Congenital heart disease flashcards

• Cardiology consultation: confirm the diagnosis, repair status, residual defects, cardiac function, medications, and need for prophylaxis.

• Prophylaxis: for qualifying cardiac anatomy and gingival/periapical manipulation or mucosal perforation, use the indicated single dose 30–60 minutes before. Apply procedure exemptions: routine local anesthesia through noninfected tissue, radiographs, removable appliance placement, orthodontic adjustment/bracket placement, natural exfoliation, and traumatic lip/mucosal bleeding do not require IE prophylaxis. AAPD 2026.

• Antithrombotic medication: identify the specific drug and plan local hemostasis. INR assessment applies to warfarin, not to every anticoagulant or antiplatelet drug. ADA dental guidance.

• Sedation and GA: Sedation and general anesthesia: hospital setting for complex or unstable patients

• Prevention: Aggressive prevention before cardiac surgery and throughout life; dental infection is an endocarditis risk

• Tooth prognosis: Choose restoration, pulp therapy, or extraction from pulpal diagnosis, restorability, expected tooth survival, follow-up access, and cardiac treatment timing. High IE risk alone is not a blanket indication to extract a restorable primary tooth

• Antithrombotic changes: do not stop or reduce prescribed anticoagulants or antiplatelets independently. Most routine dental procedures can use local hemostasis; higher bleeding risk or extensive surgery needs a prescriber-directed plan. ADA: medication management.

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Confirm cardiac eligibility with cardiology and apply dental procedure exemptions. This pathway addresses infective endocarditis; compromised-host indications are separate.

AAPD 2026.