Dental clearance and postoperative heart infections: Observations from a preoperative evaluation clinic for day-admission surgery

Every year, two-million hospitalised patients develop healthcare-associated infections with a consequent mortality eclipsing 90,000. The literature suggests that dental infections are one of many potential sources of these infections and may be associated with an increased risk of endocarditis in surgical patients, especially those undergoing cardiac procedures, though some studies have conversely shown no heightened risk of cardiac infections in patients forgoing pre-surgical dental screenings. We sought to elucidate whether patients seen at our preoperative evaluation clinic who obtained pre-surgical dental clearance experienced improved outcomes compared to those who did not receive dental clearance prior to their surgical interventions. The medical records of 196 consecutive patients were reviewed who were seen at the pre-anaesthesia evaluation prior to elective cardiac surgery from July 2017 to February 2018. Of this cohort, 102 patients had pre-surgical dental clearance, while 94 did not have dental clearance. Preoperative demographic and comorbidity data were analysed using independent t-tests. We found no significant differences between these group in terms of post-operation infections (zero instances versus four instances, p > 0.05), length of intensive care unit stay (two days versus two days, p = 0.815), or mortality associated with elective cardiac procedures (zero instances). Further evaluation of preoperative dental clearance and its potential to prevent morbidity (e.g. postoperative infections) is warranted.