TRY ANSWERING this question. Can the neglect of one’s personal oral hygiene result in death for that person? Is dental disease so innocuous that it is incapable of killing? Well, the sad fact remains that anyone can actually die from such. It is true that of the ten fatal diseases which originate from deficient care of the mouth, infection of the heart by Streptococcus viridians, arising from the oral flora, is perhaps among the most common.
Rheumatic fever is an acute fever, generally of childhood and adolescence, in which inflammation of the joints (arthritis) is often the most prominent symptom (hence the name). However, as a far more serious consequence, the heart may become permanently damaged, and it can happen due to dental or sometimes throat infections with Streptococcus bacteria. The bacteria travel from the infected site through the blood stream to the heart valves.
The good news is that only a small percentage of persons with this type of infection develop the complication which appears 10 to 14 days afterwards. High fever of sudden onset is accompanied by arthritis, skin nodules and rashes. Involuntary movements, called chorea, may occur in conjunction with rheumatic fever. In some patients, arthritis affects one joint after another with overlying skin becoming red and every movement causing pain. On others, however, the joint pain may be mild and thus regarded as ‘growing pains’.
Acquired endocardial disease is mainly rheumatic heart disease involving impaired function of the cardio valves. Acute rheumatic fever can cause immediate crisis and death as a result of inflammatory effects to the myocardium (heart muscle). The major medical impact is the possible deformity of heart valves. The thin, translucent heart valve tissue swells and thickens, and as the inflammation subsides over a long period of time, the valves form the scar tissue. In some instances, the tissues fuse together and obstruct normal blood flow through the valves, a condition known as stenosis.
Valves on the left side of the heart usually receive more damage than do valves of the right heart chambers. In some cases, valve flaps are scarred in such a way that they cannot close, resulting in regurgitation of blood. Both obstructive and permanent separation can be detected with a stethoscope as heart murmurs, which are abnormal heart sounds. Both result in heart disease, because they overtax the pumping ability of the myocardium.
Bacterial invasion of deformed heart valves causes a serious ailment called bacterial endocarditis. This disease is usually fatal if not treated adequately. The medical and dental literature provides abundant information on the means and ways to provide infective endocarditis. Antibiotic drugs taken for long periods before and after an extraction are the traditional method of prevention. But when one is considering approaches to the prophylaxis of infective endocarditis, at least five major elements that play an essential role in defining the probabilities of developing the condition must be taken into account. These are the patients’ history, age, the type of heart defect, the type of bacteria, and the number of germs that penetrate into the blood stream.
How should you as a patient act to avoid these dreaded consequences of a simple extraction? First, be cautious with rheumatic fever. If you have ever suffered from rheumatic fever, find out from a heart specialist if your heart is normal. If the cardiologist is even in doubt, personally accept this as your new status, whereby precaution must be taken every time you are to have a dental procedure. That involves informing your dentist so that he/she can prescribe penicillin as a prophylaxis. But more important yet, obey the laws of oral health so as to preclude the necessity of undergoing dental surgery (extraction).