Oral Medicine Practice Session 2: Controversies on the Impact of Oral Health and Dental Procedures on Infectious Cardiovascular Conditions

Featuring three 25-minute lectures from a variety of perspectives, with a 15-minute panel discussion after the session.

Martin Thornhill, MBBS, BDS, PhD, MSc, FDSRCS(Edin), FDSRCSI, FDSRCS(Eng)
Elise Riddle, MD, FAAP, FACC
Miriam Robbins, DDS, MS

Saturday, May 2
11:00 AM – 12:30 PM

David Dean, DDS, MSD


Bacteremia as a result of oral diseases and invasive dental procedures has long been implicated as a risk factor in the development of distant site infectious cardiovascular conditions of high morbidity such as infective endocarditis and infections of prosthetic cardiac devices (e.g.:  prosthetic valves and left ventricular assist devices).  Consequently, optimizing dental conditions for the prevention of infection have been a priority to cardiac and medical care teams for these patients.

However, performing invasive and/or stressful dental procedures on this population is a concern given the compromised systemic reserve of cardiac patients to withstand dental care. In addition, there is a lack of clear consensus as to the extent of dental care required to optimize patients for cardiac surgery.

Session Breakdown

11:00 AM – 11:30 AM
Infective Endocarditis Prevention: An Oral Medicine Researcher’s Perspective
Martin Thornhill, MBBS, BDS, PhD, MSc, FDSRCS(Edin), FDSRCSI, FDSRCS(Eng)
Dentist Researcher with expertise in the topic – overview of the issue at hand

11:30 AM – 12:00 PM
Oral Health and Dental Procedures Infectious Cardiovascular Conditions: The Risk of Infection from the Cardiologist’s Perspective

Elise Riddle, MD, FAAP, FACC
Cardiologist – discusses the various conditions and interventions, reviews medical and surgical management, and the concerns and implication of infections of these devices (presumably from oral sources), i.e. scope of impact “when things go wrong.”

12:00 PM – 12:30 PM
Oral Health and Infectious Cardiovascular Conditions: Does the Risk of Dental Therapy Outweigh the Benefit in Patients with Compromised Cardiovascular Health?

Miriam Robbins, DDS, MS
Hospital dentist – discusses the dental management of such patients from a practical standpoint – can even present actual example cases (e.g. a patient with severe compromised in functional reserve, ASA III, is referred for extensive dentoalveolar surgery to decrease risk for IE)

Learning Objectives

  1. Provide an overview of cardiac conditions and interventions that are implicated to be impacted by oral health from an infectious standpoint. (i.e.:  infective endocarditis, prosthetic valves, left ventricular assist devices, pacemakers, etc.) 
  2. Review the latest literature on the impact of oral diseases and dental procedures on the development of distant site cardiovascular infectious conditions. 
  3. Review the literature (to include latest consensus guidelines) surrounding prophylactic antibiotic therapy, and the efficacy of preventative dental care in the prevention of infectious cardiac conditions. 
  4. Outline the issues surrounding the provision of dental care in the management of cardiac patients, outlining the risks vs. benefits, and the modifications and precautions required when administering treatment.

About the Presenters

Martin Thornhill,  MBBS, BDS, PhD, MSc, FDSRCS(Edin), FDSRCSI, FDSRCS(Eng) 

Professor Thornhill is a clinician and researcher involved in multiple studies concerning the impact of dental disease and antibiotic prophylaxis in cardiac patients. This includes the impact of antibiotic prophylaxis for dental procedures and incidence of infective endocarditis, in large scale databases of patients in the United States and in the United Kingdom. He is also involved in the multicenter study evaluating oral health in patients with infective endocarditis. 

Elise Riddle, MD, FAAP, FACC

Dr. Riddle is a pediatric cardiologist at Orlando Health. She will provide a review from a medical perspective of the various cardiac conditions, current treatment recommendations, and issues with respect to infectious cardiac conditions.

Miriam Robbins, DDS, MS

Miriam R. Robbins, DDS, MS is the Chair of the Department of Dental Medicine at NYU Winthrop Hospital and the Department of Family Dental Medicine at the NYU Long Island School of Medicine in Mineola, NY. She received her dental degree from SUNY at Buffalo School of Dental Medicine and her MS in Management and Health Policy from the Robert Wagner School of Public Policy at NYU. She completed her residency at Columbia Presbyterian Medical Center and an American Cancer fellowship at Memorial Sloan-Kettering Cancer Center, both in New York City. She is a past president of the Special Care Dentistry Association as well as the American Academy of Oral Medicine. She lectures nationally and internationally as well as contributing to the dental and medical literature on the dental management of special needs and medically complex patients.