Congestive heart failure (CHF), a condition in which the heart cannot pump enough blood to the body's organs, affects more than 3 million people in the United States, with approximately 400,000 new cases each year.

People with a history of an untreated or poorly managed CHF, may be at high risk during a dental treatment for infection, cardiac arrest, stroke and heart attack, according to the lead author of a new study that appears in the May/June 2002 issue of General Dentistry, the clinical, peer-reviewed publication of the Academy of General Dentistry (AGD).

"Bacteria released during a dental cleaning travels through the bloodstream and to the areas that help pump blood to other organs," says Nelson L. Rhodus, DMD, MPH, lead author of the study. "Patients with untreated CHF are at high risk for infections because the bacteria released can trigger blood clots that may exacerbate the existing condition."

Dr. Rhodus hopes his findings help increase patient awareness about getting CHF under control so patients can receive dental treatment.

General dentists develop dental plans on a regular basis for a wide variety of patients with heart problems, says AGD spokesperson Derek Ichimura, DDS. "Heart patients need special care. Communication is key. Don't assume your dentist knows your medical history."

"Share an up-to-date medication list and other heart conditions with your dentist before every appointment," encourages Dr. Rhodus. "Share your cardiologist's information so your dentist can consult with him or her prior to your appointment."

Dentists don't prescribe medications specifically for the treatment of CHF but may do so for conditions associated with it. For example, valve damage of the heart is often associated with CHF. An antibiotic preventative treatment (prophylaxis) may be recommended for dental procedures that may cause gum bleeding or any other procedure that may introduce bacteria into the bloodstream.

In addition to CHF, other heart conditions make it necessary to take special precautions before dental care, including, angina, heart attack, heart valve disorders and pacemakers.

• Always inform your dentist if you suffer from any heart condition.
• Explain the nature of your problem and if it is under control.
• Always inform your dentist if you suffer from any heart condition.
• Always inform your dentist if you suffer from any heart condition.