Major approaches to dental treatment in patients with cardiovascular disease: a concise systematic review

Abstract

Introduction: Cardiovascular diseases can have a congenital origin, that is, present from birth, such as interatrial and interventricular communication, defects of the artery, coronary arteries, or acquired coronary artery anomalies that involve several risk factors such as smoking, alcohol, old age, and a sedentary lifestyle. Thus, acquired ones are the most frequent in the routine of a dental practice, so the dentist should be able to attend to those patients who need special care, regarding the correct use of medications due to the risk of drug interactions, the type of local anesthetic to be used, and the management of patients who use anticoagulant therapy. Objective: It was to analyze the major approaches to dental treatment in patients with cardiovascular disease. Methods: A search was made in the databases Scopus, Embase, Scielo, PubMed, and Academic Google in the period 2003 to 2026, following the rules of systematic review-PRISMA. Results: A total of 36 papers that were submitted to the eligibility analysis were collated and, after that, 18 studies were selected. Most studies presented homogeneity in their results, with Chi-Square (X²)=79.7%>50%. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 07 studies with a high risk of bias and 04 studies that did not meet GRADE and AMSTAR-2. In all cases of patients with cardiovascular diseases, the preoperative anamnesis should be done with all the details, always observing the risk factors, that progress to include the medications used; if the patient makes use of cardiac prostheses, monitor the vital signs before and after dental procedures, always recording all occurrences and procedures in medical records. Conclusion: It is necessary for the dental treatment of these patients with heart disease to have good knowledge of the subject and requires medical and dental coordination. Dental surgeons need to be prepared to identify possible medical and dental emergencies and take steps to prevent or treat them effectively and quickly.