From the Guidelines
Inform your dentist about your internal defibrillator before any dental procedure to ensure they take necessary precautions to avoid interfering with the device. When consulting with your dentist, it is essential to discuss the potential risks of electromagnetic interference from dental equipment, such as ultrasonic scalers and electrosurgery equipment, which could trigger inappropriate shocks or affect defibrillator function 1. The dentist may need to use alternative methods, such as hand instruments, for cleaning and other procedures to minimize the risk of interference. However, according to the most recent guidelines, antimicrobial prophylaxis is not recommended for dental or other invasive procedures not directly related to device manipulation to prevent CIED infection 1. It is crucial to position yourself semi-upright rather than flat during treatment to reduce cardiac stress. If you experience any unusual symptoms during treatment, alert the dentist immediately. It's also helpful to bring your defibrillator identification card and have your cardiologist's contact information available in case the dentist needs to consult with them about specific precautions for your case. Some key considerations for your dentist include:
- Avoiding the use of electrical devices that could interfere with your defibrillator
- Using alternative methods for cleaning and other procedures
- Positioning you semi-upright during treatment
- Being aware of the potential risks and taking necessary precautions to ensure your safety during the procedure.
From the Research
Implantable Cardioverter Defibrillator (ICD) Considerations
- When discussing a patient's internal defibrillator with a dentist, it is essential to consider the patient's overall cardiac health and any potential risks associated with dental treatment 2.
- The dentist should be informed about the patient's ICD and its functionality to ensure safe delivery of dental care 3.
- Patients with ICDs may have limited understanding of their device and its functions, so it is crucial to provide clear information and communication about their treatment plan 3.
Dental Treatment Considerations
- Dental extraction of abscessed or infected teeth before cardiac operation is frequently advocated to lower the risk of infections, especially infective endocarditis 4.
- The provision of dental treatment under both local anaesthesia and sedation has an excellent safety record, although medical problems may occur 2.
- Dentists should be aware of the potential risks and take prophylactic and remediable measures to enable safe delivery of dental care for patients with cardiac disease 2.
ICD Functionality and Patient Information
- Patients and family members require improved communication and information concerning their future treatment plan and functionality of an ICD 3.
- A proactive approach to discuss deactivation of the ICD would enable shared clinical decision-making in the advanced stages of illness 3.
- The eligibility of patients with pacemakers for subcutaneous implantable cardioverter defibrillators (S-ICDs) should be considered, and the QRS:T-wave ratio screening template can be used to determine candidacy 5.