Oral findings and dental treatment in 15 patients undergoing heart transplantation

Heart transplantation has substantially increased since cyclosporin became clinically available as an immunosuppressive drug in the 1980's, and the recent survival rate after heart transplantation has increased.The major complication after heart transplantation is infection associated with the side effects of immunosuppressive therapy. Because we can prevent infection originating from oral lesions, evaluation of patients' oral health and removal of any potential source of infection is important both before and after heart transplantation.We studied 15 patients after heart transplantation for whom dental examinations and treatment were requested by the Department of Internal Medicine of our hospital. Twelve decayed teeth were found in 3 patients, 52 teeth with marginal periodontitis in 4, 2 teeth with apical periodontitis in 2, 147 teeth with gingival enlargement in 9, mobility of a deciduous tooth in 1, 1 tooth with hypodontia in 1, and 1 fused tooth in 1. All patients received an explanation on tooth brushing. Eight teeth were extracted in one patient during the period before and after heart transplantation. Dental calculi were removed from 22 teeth in 2 patients.We report the details of these oral lesions and discuss the appropriate period for dental procedures and optimal antibiotic treatment.