Assessing Dentists' Awareness and Strategies for Managing Patients with Heart Failure
Abstract
Objective: Heart failure (HF) patients pose unique challenges for dental practitioners due to the complex medical conditions and medications associated with HF. This study aimed to assess the knowledge, clinical practices, confidence, and training needs of dentists in managing HF patients.
Methods: A cross-sectional survey was conducted among 202 dentists. The survey explored demographic characteristics, knowledge of HF, clinical practices, confidence in managing HF-related emergencies, and interest in further training. Statistical analyses, including chi-square tests and independent samples t-tests, were used to identify associations between factors such as experience, training, and confidence levels.
Results: Only 38.6% of respondents had formal training in handling medically compromised patients, while 65.3% were aware of HF-related oral health complications. The most commonly recognized HF symptoms were shortness of breath (81.7%) and swollen legs (73.3%). Anticoagulants (67.8%) and beta-blockers (55.4%) were identified as the most relevant medications affecting dental treatment. Although 63.9% of dentists always inquired about cardiovascular history, only 21.8% regularly consulted a cardiologist before treating HF patients. Confidence in managing HF emergencies was moderate, with 55.0% feeling somewhat confident and 26.7% not confident. Importantly, 79.7% of dentists expressed interest in HF training workshops. Statistical analyses revealed a significant association between dentists' years of experience and confidence in managing HF emergencies (p = 0.003), as well as a significant difference in confidence levels between those with formal training (M = 3.5, SD = 0.9) and those without (M = 2.8, SD = 1.1, p = 0.002).
Conclusions: While dentists generally possess good awareness of HF symptoms and associated oral health risks, there are significant gaps in clinical management and confidence in handling HF-related emergencies. Further education and structured training programs are essential to improve dentists’ preparedness and ensure better care for HF patients. Enhanced interdisciplinary collaboration with cardiologists is also recommended to improve patient outcomes.
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Virani, S. S., Alonso, A., Aparicio, H. J., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., ... & Tsao, C. W. (2021). Heart disease and stroke statistics—2021 update: A report from the American Heart Association. Circulation, 143(8), e254-e743.
Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G. F., Coats, A. J. S., ... & van der Meer, P. (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal, 37(27), 2129-2200.
Ziaeian, B., &Fonarow, G. C. (2016). Epidemiology and aetiology of heart failure. Nature Reviews Cardiology, 13(6), 368-378.
Neskovic, A. N., Ajduk, M., Belenkov, Y., Nikolov, P., & Varga, A. (2021). Heart failure and its implications for dental practice: Risk assessment and management strategies. Journal of Cardiovascular Medicine, 22(3), 125-135.
Al-Khatib, B., Raad, M., Abdallah, J., &Kassir, R. (2022). Implications of cardiovascular medications on oral health: A review of side effects and dental considerations. Journal of Clinical Medicine, 11(4), 1125.
Dörfer, C. E., Joas, S., & Dietrich, T. (2021). The impact of cardiovascular medications on periodontal health and dental treatment outcomes. Periodontology 2000, 87(1), 193-204.
Javed, F., Ahmad, P., & Correa, F. O. (2013). Oral health status in individuals with cardiovascular disease: A systematic review. Journal of the American Dental Association, 144(10), 1141-1149.
Lockhart, P. B., Bolger, A. F., Papapanou, P. N., Osinbowale, O., Trevisan, M., Levison, M. E., ... & Baddour, L. M. (2019). Periodontal disease and atherosclerotic vascular disease: Does the evidence support an independent association? Circulation, 139(2), 201-212.
Sanz, M., Marco del Castillo, A., Jepsen, S., Gonzalez-Jaranay, M., D'Aiuto, F., Bouchard, P., ... &Tonetti, M. S. (2020). Periodontitis and cardiovascular diseases: Consensus report. Journal of Clinical Periodontology, 47(3), 268-288.
van der Meer, W. J., Vissink, A., Aartman, I. H. A., van Wijk, A. J., & de Jongh, A. (2017). Oral health in patients with heart failure: A systematic review and meta-analysis. European Journal of Heart Failure, 19(3), 279-285.
Pattanshetti, V. M., Jadhav, H. C., &Bommanavar, S. (2020). Dental management of patients with cardiovascular diseases: A comprehensive review. Journal of Clinical and Diagnostic Research, 14(5), ZE01-ZE05.
Glick, M., Greenberg, B. L., & Ship, J. A. (2019). Managing medically complex patients: The role of oral health in systemic disease. Journal of the American Dental Association, 150(9), 781-789.
Liau, C. S., Chiu, C. W., & Lee, C. M. (2020). Cardiovascular considerations in dental care: Managing patients with heart failure. International Journal of Cardiology, 312, 25-30.
Zhang, H., Wang, Y., & Liu, X. (2020). Barriers in dental management of medically compromised patients: A survey among dental professionals. BMC Oral Health, 20(1), 289.
Soleymani, F., Alizadeh, M., & Mohseni, H. (2021). Knowledge and attitudes of dental practitioners regarding the management of patients with cardiovascular diseases. Journal of Oral Health and Preventive Dentistry, 19(2), 120-128.
Bailey, J. R., Smith, L. M., & Cooper, J. T. (2022). The importance of interdisciplinary collaboration in dental and cardiovascular health: A systematic review. Journal of Oral Health and Preventive Medicine, 15(3), 142-150.
Acharya, A., Cheng, B., Koralkar, R., & Leong, T. (2018). Barriers to interdisciplinary collaboration between dental and medical professionals in managing cardiovascular patients: A survey-based study. Journal of Interprofessional Care, 32(1), 75-81.
Malki, G., Al-Sabri, F., & Saleh, H. (2018). Continuing education programs and awareness of oral-systemic health connections among dental practitioners. International Journal of Dental Education, 34(2), 97-105.
Al-Khabbaz H, et al. Systemic diseases and their oral manifestations in dental practice: A review. J Clin Dent. 2020;45(3):123-134.
Silva C, et al. Oral health complications in patients with cardiovascular diseases. Int J Oral Sci. 2019;11(2):65-72.
Habbab K, et al. Dental management of patients on anticoagulant therapy: A systematic review. J Oral Med. 2018;50(4):215-229.
Kumar R, et al. Awareness of cardiovascular drugs' impact on oral health among dentists. J Dent Res. 2021;100(1):58-65.
Tanasiewicz M, et al. Multidisciplinary approach in dental care for medically compromised patients. J Clin Oral Investig. 2022;26(7):1958-1968.
Rashid A, et al. Interdisciplinary collaboration between dentists and cardiologists: A review. J Cardiovasc Dent. 2021;12(5):305-312.
Bensalem A, et al. Emergency preparedness among dental professionals. Int Dent J. 2020;70(5):230-238.
Ouanounou A, et al. Medical emergencies in dental practice: Knowledge and preparedness of dentists. J Dent Educ. 2021;85(9):1056-1064.
Park SY, et al. The impact of clinical experience on dentists' confidence in managing medical emergencies. J Am Dent Assoc. 2019;150(2):123-130.
Alzahrani FS, et al. Effectiveness of continuing education programs in improving dentists’ confidence in handling medically compromised patients. Saudi Dent J. 2022;34(1):50-58.
Frolow M, et al. Dentists' perception of training needs for managing patients with systemic diseases. BMC Oral Health. 2020;20(1):92.
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