A national survey of dental protocols for the patient with a cardiac transplant

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Abstract
To assess current practice of dental protocols for the patient with a cardiac transplant, a 19-question survey was designed and distributed to all general practice and oral surgery residency programs accredited by the American Dental Association. Analysis of the survey demonstrates a great amount of variability in the protocols used in this field. With the discovery of cyclosporine in 1976 by Borel, organ transplantation surgery has become increasingly common. This is especially true of heart transplantation. Success rates have increased dramatically in recent years; they are now documented at 81% at 1 year, 74% at 2 years, and 50% at 5 years. The two primary causes of death after cardiac transplantation are organ rejection and infection. Cyclosporine and azathioprine have improved the delicate balance between preventing organ rejection and encouraging infections. However, numerous bacterial infections, viral infections, and fungal infections may originate in the mouth and become life-threatening problems. For this reason, dentists must be members of the cardiac transplant teams and a nationally accepted dental protocol should be devised to ensure proper patient care.

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