Tooth extraction before CABG? why?

  1. Hello,

    I am a fairly new telemetry nurse, I have noticed that whenever a pt is going to be going for open heart or CABG surgery they get an xray for mandible series and they have surgery for tooth extraction. I am thinking this is in some way to prevent infection after the surgery but I am not sure. Can anyone please explain? It would be greatly appreciated.:redpinkhe

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    About I care there4 I amRN

    Joined: Jul '10; Posts: 8; Likes: 3


  3. by   SandraCVRN
    I've seen this with valves and only on those with really bad dentition not as a routine pre-op.
  4. by   I care there4 I amRN
    thx for ur response, i think that was the case, the pts i have seen have the procedure all had some dental issues.
  5. by   nursej22
    Streptococcus viridans, an normal oral flora, has a high affinity for endocardium and heart valves. When it enters the bloodstream as a result dental work or periodontal disease it can attack the heart valves resulting in vegetation and erosion as well as septic emboli.
    Poor dental hygiene is often the culprit in endocarditis so the bad teeth are often removed prior to valve replacement, otherwise the new valve gets infected too.
    And that seldom has a good outcome.
  6. by   I care there4 I amRN
    ur response was very detailed and really clarified some things for me
  7. by   dr_mike_chiro
    Just posted some videos on reducing risk
    of heart surgery complications from triple bypass, CABG, Carotid Artery Endarterectomy, at


    Feel free to email me at
  8. by   I care there4 I amRN
    thanks I will watch the videos
  9. by   KD CVICU-RN
    The bacteria that are produced from either periodontal disease, or as I am assuming in this case, the death of the pulp of the tooth can get into the circulation blood. That all just means that the patient would need to have a root canal, or if it was beyond saving, an extraction. When a tooth dies, it becomes interally necrotic and releases these gram-neg. bacteria which circlate throuout the bloodstream, eventually causing growths of bacterial vegetation within the heart.

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