A survey to evaluate the management of orthodontic patients with a history of rheumatic fever or congenital heart disease
A survey concerning the orthodontic management of patients with a history of rheumatic fever or congenital heart disease was mailed to a random sample of 500 orthodontists throughout the United States. Two hundred thirtytwo surveys were completed and returned. Analysis revealed that 88% of the respondents were aware that they should screen for patients with a history of rheumatic fever or congenital heart disease, only 11% used the antibiotic regimen recommended in 1977 by the American Heart Association11 (see Fig. 2), one half of the respondents thought it was necessary to provide antibiotic coverage during banding, and 38% deemed it necessary for debanding procedures which were likely to cause some degree of bleeding from the gingival sulcus. Only one half of the respondents would discontinue treatment if a condition of gingivitis developed which did not show signs of improvement, and only 70% provided medication for orthodontic procedures that could result in bacteremia. Furthermore, the results of this survey indicated that there was a great variation in the antibiotic regimen of orthodontic treatment for patients at risk of developing endocarditis and that there was a need to make the orthodontist more aware of the 1977 recommendations of the American Heart Association.11 Finally, a comparison between the year of graduation from an orthodontic program and the number of respondents who did not screen for or did not premedicate at-risk patients revealed a direct relationship. The earlier the education, the smaller the number of respondents who screened or premedicated. This survey revealed that a relatively high percentage of orthodontists do not premedicate patients who are at risk of developing bacterial endocarditis, and it was found that, of those who did premedicate, a great variation existed in their premedication regimens. This information indicates a need for the practicing orthodontist to review the most current recommendations of the American Heart Association, but it must be emphasized that the American Heart Association guidelines have just been revised (see Fig. 1) and, therefore, the orthodontist should be alerted for future changes in order to be current and also to be legally protected. © 1985.
Gaidry, Donald; Kudlick, Earl M.; Hutton, Jack G.; and Russell, Donald M., "A survey to evaluate the management of orthodontic patients with a history of rheumatic fever or congenital heart disease" (1985). College of Dentistry Faculty Publications. 179.