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Treatment of oral infections prior to heart valve surgery does not improve long-term survival

Journal article
Authors John Bratel
Charles Kennergren
Leif Dernevik
Magnus Hakeberg
Published in Swedish Dental Journal
Volume 35
Issue 2
Pages 49-55
ISSN 0039-6745
Publication year 2011
Published at Institute of Odontology
Institute of Medicine, Department of Emergeny and Cardiovascular Medicine
Institute of Medicine, Department of Molecular and Clinical Medicine
Pages 49-55
Language en
Subject categories Medical and Health Sciences, Dentistry, Odontological behavioural science


The objective was to evaluate the importance of preoperative elimination of oral infections and oral health for survival after heart valve surgery In a group of patients (n=149; treatment group, GP group), oral health was examined and dental treatment was performed 3-6 months prior to heart valve surgery. In a second group (n=103; control group, SP group), oral health was examined postoperatively, but patients did not receive dental treatment prior to surgery. Sixteen years after heart valve surgery was performed, morbidity endpoint data were obtained. Differences in survival between the two groups and the influence of differences in oral health were analyzed. Fewer patients survived in the study group (37%) compared with the control group (45%). Mean survival was 122.9 months in the GP group compared with 143.3 months in the SP group, including time to death and those alive at the endpoint (p=0.018). A positive relationship was found between the number of teeth and survival, with RR = 0.98 (95% CI 0962-0.996 (p=0.016)).The deaths from heart valve disease were 18% in the GP group and 7% in the SP group (chi2=3.65, df=1, p=0.56). At the long-term follow-up,the results of the present study show,that it was not possible to demonstrate that dental treatment before heart valve surgery improved survival. Therefore, the need for extensive dental treatment prior to heart valve surgery may be reconsidered.

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