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成人先天性心脏病患者口腔健康的意义。

Significance of oral health in adult patients with congenital heart disease.

作者信息

Folwaczny Matthias, Bauer Florian, Grünberg Christina

机构信息

Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Munich, Germany.

Department of Oral and Maxillofacial Surgery, University of Technology Munich, Munich, Germany.

出版信息

Cardiovasc Diagn Ther. 2019 Oct;9(Suppl 2):S377-S387. doi: 10.21037/cdt.2018.09.17.

Abstract

Due to improved diagnosis and treatment life expectancy of patients with congenital heart disease is steadily increasing resulting in a growing portion of adult patients. When entering, adulthood patients commonly show a shift in their specific needs for medical care. Since the treatment is mostly not curative many patients have life-long cardiovascular anomalies, among others, entailing high risk for the development of infective endocarditis. Several oral diseases, i.e., caries, apical periodontitis and periodontitis show a very high overall prevalence. These entities are primarily initiated by bacterial infections. Hence, they cause an inherent risk for bacteremia and subsequently for infective endocarditis in patients with congenital heart disease during professional dental care and various daily activities. Conversely congenital heart disease seems to be inevitably associated with considerable impairment of oral health resulting in a tight interrelation between both entities. Different preventive strategies are available to address the elevated risk for infective endocarditis due to oral diseases in patients with congenital heart disease during professional dental care and routine daily activities. This review delineates the current evidence regarding the issue of oral health in adult patients with congenital heart disease.

摘要

由于诊断和治疗水平的提高,先天性心脏病患者的预期寿命在稳步增加,成年患者的比例也在不断上升。成年后,患者的医疗护理特殊需求通常会发生变化。由于治疗大多无法治愈,许多患者患有终身心血管异常,其中包括感染性心内膜炎发生风险较高。几种口腔疾病,如龋齿、根尖周炎和牙周炎的总体患病率非常高。这些疾病主要由细菌感染引发。因此,在专业牙科护理和各种日常活动中,它们会给先天性心脏病患者带来菌血症风险,进而引发感染性心内膜炎。相反,先天性心脏病似乎不可避免地与口腔健康的严重损害相关,导致这两种情况之间存在紧密的相互关系。在专业牙科护理和日常活动中,有不同的预防策略可用于应对先天性心脏病患者因口腔疾病而增加的感染性心内膜炎风险。本综述阐述了关于成年先天性心脏病患者口腔健康问题的现有证据。

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本文引用的文献

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Characterization of oral microbiota and acetaldehyde production.口腔微生物群的特征及乙醛生成
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Position Paper: Systemic Antibiotics in Periodontics.立场文件:牙周病学中的全身用抗生素
J Periodontol. 2004 Nov;75(11):1553-1565. doi: 10.1902/jop.2004.75.11.1553.

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