Stefana Maria Moisa, Ingrith Miron, Ancuta Lupu, Iosif Leonard Pertea, Gabriela Paduraru, Vasile Valeriu Lupu
Since cardio-vascular diseases are widely prevalent in the general population, any dental medicine practitioner is bound to face any number of such patients. Apart from knowing the optimum approach regarding therapy and anesthesia in hypertensive, angina, heart failure, coronary disease or arrythmia patients, the dental medicine practitioner may sometimes be the first to diagnose the presence of a cardiac disease. Some may notice the Muller sign- pulsations of the uvula, signaling severe aortic regurgitation. Others may diagnose Marfan syndrome that can be associated at some point with aortic pathology, based on the typical facial characteristics of the patient- convex profile, micrognathia, retrognathia, deep palate and dolichocephaly. Hypertensive and rheumatic heart disease patients have been demonstrated to suffer from xerostomia, median rhomboid glossitis, angular cheilitis, stomatitis, lichen planus, or aphthous ulcers. Xerostomia can also be encountered as a medication side effect, as can lichen planus, gingival hyperplasia and bleeding, loss of taste sensation and dysgeusia or sialadenitis. Up to 67.4% of patients treated for their heart condition may have potential oral manifestations, induced by their disease or its treatment.
Craniofacial pain has often a local origin, but an atypical case of angina should not easily be ruled out. Cyanotic congenital heart malformations are characterized by cyanotic oral mucosa, delayed teeth eruption, enamel hypoplasia and increased frequency of positional abnormalities. Other associated abnormalities include geographic tongue, marginal gingivitis, stomatitis, periodontitis and periodontal destruction. Tooth pain may be caused by pulpal engorgement in these patients.