An audit of pre-operative dental radiographs in patients who received no pre-operative dental input before cardiovalvular surgery

Purpose To radiographically characterise dental disease burden and related characteristics of referred patients awaiting cardiovalvular surgery (CVS) in the context of infective endocarditis (IE) risk.Methods Radiographic evidence of dental disease levels was assessed for patients referred for dental assessment pre-CVS using available orthopantomographs (OPTs) prescribed by the cardiology team. This group did not receive any pre-CVS dental intervention or treatment.Results The majority of OPTs were Quality Standard 2 (87.5%). There was radiographic evidence of dentoalveolar disease in those patients proceeding to CVS. Periodontal disease was most prominent, with 79% of patients having advanced bone loss. The mean number of apical lesions was 0.71. Overall decayed, missing, and filled teeth score was 16.4, along with mean missing teeth scores of 7.9. None of the patients have so far developed IE at a minimum of six-month follow-up.Conclusions In our context, the quality of the radiographs requested by non-dental clinicians and delivered by non-dental-school-based radiographic departments is suboptimal and needs to be addressed. This audit should help to inform the debate around the timing and delivery of evidence-based, specialist dental care for CVS patients. Chronic dental disease is often untreated and poses a major risk for patients vulnerable to infective endocarditis.Highlights the importance of preventive dental care and non-surgical periodontal treatment to reduce the risk of everyday bacteraemia from periodontal disease.Dental radiographic imaging should be appropriate and diagnostically acceptable, requested and interpreted by the dental clinician.A shared care approach is necessary alongside general dental practitioners and hospital specialists for the management of chronic dental disease. Oral surgery has a role in treating acute sources of infection.