Necessity of dental restoration before heart valve replacement: a cross-sectional study of a historical cohort

Objectives: This study aimed to assess the dental status of patients referred for preoperative dental evaluation prior to heart valve replacement, to analyze the consultation process, and to determine the necessity of dental-surgical intervention. Materials and methods: This retrospective study included only outpatients referred for dental focus screening before heart valve replacement between January 1, 2020, and March 31, 2024. Results: The 66 patients included had a median age of 68.5 years (33.3–88.4) and comprised 16 women and 50 men. Valve replacements were distributed as follows: 65.2% aortic, 27.3% mitral, 1.5% pulmonary, and 6.0% unknown. In 89.4% of cases, outpatient consultation occurred ≤ 10 days before surgery. The DMFT index was 20.0 (10–28) in aortic and 18.5 (6–28) in mitral valve disease (p = 0.209). Patients with dental restorations had a DMFT of 20.0 (12–28), and those without had 17.5 (12–28) (p = 0.304). A significant but weak correlation was found between the DMFT index and heart valve disease (ρ = -0.277; p = 0.029). In 48.5% (n = 32), oral and maxillofacial surgical intervention was indicated. Among patients requiring intervention, 60.5% had aortic and 22.2% mitral valve disease (p = 0.007). Conclusion: Future efforts should prioritize interdisciplinary education and patient engagement to prevent the rare but serious prosthetic valve endocarditis, aiming to reduce adverse outcomes after valve replacement. Clinical relevance: Given the increasing incidence of prosthetic valve infective endocarditis (PVE), this study highlights the critical role of preoperative dental assessments in identifying potential oral foci. Nearly half of the patients required oral or maxillofacial surgical intervention before heart valve replacement, emphasizing the importance of timely interdisciplinary collaboration. Integrating dental evaluations into the standard preoperative protocol may help reduce postoperative complications and improve patient outcomes.