Modern aspects of prevention of bacteremia in patients with chronic rheumatoid heart disease in dental practice

  • O. O. Myhal Danylo Halytskyi Lviv National Medical University
  • R. Z. Ohonovsky Danylo Halytskyi Lviv National Medical University
Keywords: chronic rheumatic heart disease, transient bacteremia, dental pathology, specific and non-specific prophylaxis


Chronic rheumatic heart disease (CRHD) occurs as a result of a severe acute rheumatic fever with heart failure as a result of inflammation caused by β-hemolytic group A streptococcus due to the slowing down of the immune response to streptococcal infection and the further development of boundary fibrosis and sclerosis of the connective tissue of the valvular heart. Approximately 60 % of patients with acute rheumatic fever have, with time, CRHD, with the highest frequency of valvular heart disease within 1–3 years of the first attack of acute rheumatic fever [1].

The aim of the study – to present to dentists modern aspects of prevention of transient bacteremia in patients with chronic rheumatic heart disease (CRHD), as well as recommendations to accompany this dispensary group at the reception of a dentist.

Materials and Methods. A review and analysis of the scientific and medical literature for 2008–2018, reporting materials of methodological and scientific organizations, current regulatory documents. The main directions for the prevention of complications of the course of chronic respiratory distress syndrome associated with medical interventions, in particular the provision of dental care, accompaniment to persons with dental diseases are highlighted.

Results and Discussion. The issues of the need to update dental approaches in the therapeutic accompaniment of patients with chronic rheumatic heart disease were considered. Presents modern schemes of antimicrobial prophylaxis and regulatory documents for dental interventions, taking into account the risks of transient bacteremia.

Conclusions. Due to the growing share of complications of chronic rheumatic heart disease associated with medical intervention, the individualization of dental prophylaxis of transient bacteremia in these patients becomes crucial. Therefore, in order to achieve a high level of dental sanitation, it is necessary to improve the measures of specific and nonspecific prevention of transient bacteremia, which is extremely important for preventing the progression of complications of chronic rheumatic heart disease.


Tikhonchuk, N.S. (2008). Zastosuvannia ozonoterapii v kompleksnomu likuvanni khvorykh z mitralnymy vadamy sertsia revmatychnoi etiolohii [Application of ozonotherapy in complex treatment of patients with mitral defects of heart rheumatic etiology]. Candidate’s Extended abstract. Odesa [in Ukrainian].

Lysenko, H.I., & Khimion, L.V. (2013). Suchasni problemni pytannia hostroi revmatychnoi lykhomanky [Modern issues of acute rheumatic fever]. Ukrainskyi revmatolohichnyi zhurnal – Ukrainian Rheumatologist Journal, 4 (54), 6-12 [in Ukrainian].

Volosovets, T.M., & Doroshenko, O.V. (2014). Suchasni stratehii mizhdystsyplinarnoho zapobihannia infektsiinomu endokardytu: stomatolohichni aspekty [Modern strategies for snterdisciplinary prevention of infectious endocarditis: dental aspects]. Novyny stomatolohii – News of Dentistry, 2 (79), 30-34 [in Ukrainian].

Boiarchuk, O.R. (2012). Osoblyvosti subklinichnoho perebihu khronichnoi revmatychnoi khvoroby sertsia [Features of subclinical course of chronic rheumatic heart disease]. Ukrainskyi revmatolohichnyi zhurnal – Ukrainian Rheumatologic Journal, 2 (48), 28-32 [in Ukrainian].

Kuliavets, C.Iu., Kamenska, E.P., Martymianova, L.O., & Yabluchanskyi, M.I. (2013). Khronichna revmatychna khvoroba sertsia i taktyka yii likuvannia [Chronic rheumatic heart disease and its treatment tactics]. Medytsyna transportu Ukrainy – Medicine of Transport of Ukraine, 3, 75-79 [in Ukrainian].

Knysov, H.V., Vatutin, M.T., Voronkov, L.H., Iliashch, M.H., Riabenko, D.V., & Tseleuko, V.Ya. (2015). Profilaktyka, diahnostyka ta likuvannia infektsiinoho endokardytu. Rekomendatsii robochoi hrupy z khvorob miokarda, perykarda, endokarda ta klapaniv sertsia Asotsiatsii kardiolohiv Ukrainy [Prevention, diagnosis and treatment of infective endocarditis. Recommendations of the working group on diseases of the myocardium, pericardium, endocardium and heart valves of the Association of cardiologists of Ukraine]. V.M. Kovalenko, O.H. Nesukai (moderators). Ukrainskyi kardiolohichnyi zhurnal – Ukrainian Cardiology Journal, 6, 11-24 [in Ukrainian].

Stewart, R., & West, M. (2016). Increasing evidence for an association between periodontitis and cardiovascular disease. Circulation, 133, 549-551.

Farzin, М., Derafshi, R., Ghapanchi, J., Kafsh, A.Z., & Rezaiee, M. (2016). Oral manifestations of hypertension and rheumatic heart disease: A cross sectional study in elderly patients. Asian J. Med. Pharm. Res., 6 (2), 09-13.

Teles, R., & Wang, C.-Y. (2011). Mechanisms involved in the association between peridontal diseases and cardiovascular disease. J. Oral Diseases, 17 (5), 450-461.

Cruz-Pamplona, M., Jimenez-Soriano, Y., & Sarrión-Pérez, M.G. (2011). Dental considerations in patients with heart disease. J. Clin. Exp. Dent., 3 (2), 97-105.

Maharaj, D., & Vayej, A.C. (2012). Oral health of patients with severe rheumatic heart disease. Cardiovascular Journal of Africa, 23 (5), 336-339.

Dhotre, S.V., Davane, M.S., & Nagoba, B.S. (2017). Periodontitis, bacteremia and infective endocarditis: A review study. Arch. Pediatr. Infect. Dis., 5 (3), e41067.

Nakano, K., Nomura, R., & Ooshima, T. (2008). Streptococcus mutans and cardiovascular diseases. Japanese Dental Science Review, 44 (1), 29-37.

Granados-Principal, S., El-Azem, N., Quiles, J.L., Perez-Lopez, P., Gonzalez, A., & Ramirez-Tortosa, C, (2012). Relationship between cardiovascular risk factors and periodontal disease: Current knowledge, cardiovascular risk factors. Gasparyan, A. (Ed.). InTech. Available from:

Dinakaran, V. (2017). Microbial Translocation in the Pathogenesis of Cardiovascular Diseases: A Microbiome Perspective. Journal of Cardiology & Current Research, 8 (6), 00305.

Volf, G.F., Ratejchak, Je.M., & Ratejchak, K. (2008). Parodontologija: rukovodstvo. Barer, G.M. (Ed.). MEDpress-inform.

Farbod, F., Kanaan, H., & Farbod, J. (2009). Improvement in rheumatic fever and rheumatic heart disease management and prevention using a health centre-based continuous quality improvement approach. International Journal of Oral and Maxillofacial Surgery, 38 (6), 626-631.

Lockhart, P.B., Loven, B., Brennan, M.T., & Philip, C.F. (2007). The evidence base for the efficacy of antibiotic prophylaxis in dental practice. The Journal of the American Dental Association, 138 (4), 458-474.

Lang, N.P., Lindhe, J., & Karring, T. (Eds.) (2008). Clinical periodontology and implant dentistry (5th edn.). Blackwell Munksgaard.

Shanson, D. (2008). New British and American guidelines for the antibiotic prophylaxis of infective endocarditis: do the changes make sense? A critical review. Current Opinion in Infectious Diseases, 21 (2), 191-199.

How to Cite
Myhal, O., & Ohonovsky, R. (2019). Modern aspects of prevention of bacteremia in patients with chronic rheumatoid heart disease in dental practice. Clinical Dentistry, (4), 12-18.
Terapeutic stomatology