Communicating the urgency

Cemal Ucer explains the importance of dental treatments, even during a pandemic.

At present there is a heightened risk that patients are suffering in silence, delaying a practice visit and treatment while their condition deteriorates. It is entirely possible that some patients are avoiding getting treated, even for issues that have progressed to dental emergencies – which can even represent a risk to their wellbeing. 

As dental professionals we know well that while dental care is localised to the orofacial region, oral health is well-established to have wider ranging effects. Poor oral hygiene and health can have a bidirectional relationship with various systemic and psychological health issues.

Unfortunately, some patients may not grasp that delaying treatment for something like a dental abscess or failing implant could cause a cascade of further health problems. Cardiovascular problems remain among the leading causes of death in England and Wales, and a common pathway for infective endocarditis is infection via the oral cavity. Carious and infected teeth and gums can allow oral bacteria to enter the blood stream, and where a pre-existing valve defect is present this can allow bacteria to colonise and spread, which can lead to heart failure. It is also possible for the bacteria to break off and spread from this site to other organs, including the brain. Over a third of infective endocarditis cases are traceable to dental infection. While rare, infective endocarditis is fatal in around a quarter of cases, and can lead to lifelong complications in survivors. These can include stroke, heart valve replacement and perpetual anticoagulant medication. Half of all infective endocarditis cases occur in individuals without known cardiac valvular lesions.