The Tribune

By Dr Andre Clarke Heart disease is everywhere. If you listen to more than a few persons, you will hear them say, "I got a lil heart problem!" Many of them are senior in age, but more and more it seems that those persons complaining are in their 40s, 30s and even 20s. What is a "lil heart problem" anyway? Heart disease is a general term that encompasses many ailments. A few of note are Infective Endocarditis, Myocardial Infarction and Angina Pectoris. It is, therefore, important to determine exactly what type of heart disease a person complaining of a "lil heart problem" has. You would be amazed by what follows the question, "What exactly is wrong with your heart?" In the Bahamas, in the month of February, we celebrated not only National Children's Dental Health Month, but Heart Month. The month of love, is also the month of teeth and ironically, also the month of the heart. If you have a cardiovascular (heart and blood vessel) disease, when you go to your dentist, it is important to tell him or her the history of your illness, and the list of names and dosages of any medications your medical doctor has prescribed for the heart and blood vessel disease. It is important to tell the dental health care professional not only about prescription medication, but also about medication bought over the counter (non prescription). All of this information will help the dentist make the best decisions when treating you. One such decision is using medications during your dental procedures that will not harm your heart. Another is using medications that will not cross react with any of the heart medications that your medical doctor prescribed for you to take. Recent scientific research strongly suggests that gum disease has a connection to cardiovascular disease. Gum disease has been shown to be a predictor and a prognosticator (determining the probable course and outcome) of cardiovascular disease. Bacteria in the mouth are believed to directly and indirectly influence the formation of plaques in blood vessels. These plaques grow in size and block blood vessels partially or totally, eventually leading to a heart attack and/or a stroke. It therefore stands to reason that an unhealthy mouth is not only unsightly, but it may actually be slowly killing you. Infective Endocarditis is inflammation of the inner lining of the heart caused by bacteria. It can be life threatening. One of the sources of the bacteria that causes it is the mouth. It is therefore important for dentists to take precautions to prevent its occurrence in patients. Do not worry, dentists in the Bahamas follow guidelines that are published by the American Dental Association and vetted by the Bahamas Dental Association. The guidelines are meant to prevent Infective Endocarditis' occurrence in predisposed patients. Myocardial Infarction is when a portion of the heart dies because there is a stoppage in the local blood supply. When local blood supply is blocked, oxygen to the heart tissue ceases. When oxygen to the heart tissue ceases, the heart tissue dies. One common cause of such a blockage is plaque, which is made up primarily of bad fat products. The plaque, formed in the heart's blood vessels, is under the influence of mouth bacteria as mentioned above. Of note, it is generally accepted by healthcare professionals that after a Myocardial Infarction, it is best to wait six months before having extensive dental treatment done. When managing patients recovering from a Myocardial Infarction, the prudent oral care professional will make sure oxygen and/or nitroglycerin is available in their office. Angina Pectoris is chest pain that occurs as a result of reduced oxygen to the heart tissue. When there is a halt in oxygen supply, due to a stoppage of blood supply in the heart tissue, it causes tissue death and is called a Myocardial Infarction. When there is a reduction in the blood supply, and by extension the oxygen supply to the heart tissue, the heart tissue starts to die and the related pain experienced because of this is called Angina Pectoris. The blockage that eventually causes Myocardial Infarction is the same blockage that causes Angina Pectoris. In order to treat Angina Pectoris medical doctors prescribe varying types of medications. These medications can sometimes cause dry mouth and swollen gums. These are side effects of the medications. It is therefore important for the managing dentist of a patient with Angina Pectoris to know the impact of the disease on the mouth. Always remembering that the impact may be direct or indirect. The heart and the mouth are connected and whatever affects one, affects the other. Do not stay away from your dentist especially if you have a "lil heart problem". He can work with your medical doctor to improve your overall health.