Evaluation of cardiac risk in dental patients

Key Points

  • Provides a tool for cardiac risk assessment for general dental practitioners and dental specialists to supplement other commonly used methods such as the ASA scale.

  • Provides detail on how to evaluate the control of conditions associated with cardiac risk as well as the patient's functional capacity.

  • Offers practical advice on the implications for dental treatment in individual cases.


Patients with cardiac disease, cardiac symptoms and related co-morbidities are increasingly being encountered in dental practice. Current methods of medical risk assessment can however be problematic. This paper represents a multi-speciality consensus on how to identify patients that may be more at risk of an adverse cardiac event occurring perio-operatively i.e. during or in the first few weeks after a dental procedure. Drawing on guidelines for surgery and the available literature, we present on an algorithm which aims to inform dental practitioners' decisions about which patients can be managed in primary care and which should be considered for assessment by a dental specialist together with a methodology thereof.

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The authors would like to thank the following who helped in developing the algorithm: Jennifer Perry and Clare Yates StRs, and Fiona Knight Dental Officer in Special Care Dentistry, Arathi McIntosh, Harlene Kaur, Neil Donaldsen StRs, and Harriet Anstey Consultant in Oral Surgery. Also Dr Scott Russell Consultant Anaesthetist and Thomas Dietrich Professor in Oral Surgery who provided helpful comments. Finally Heather Lewis in the Graphic Design Department at Birmingham Dental Hospital for her work on diagrammatic presentation.

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Correspondence to L. K. Stenhouse.

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Ransford, N., Stenhouse, L., Townend, J. et al. Evaluation of cardiac risk in dental patients. Br Dent J 224, 615–620 (2018). https://doi.org/10.1038/sj.bdj.2018.310

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