Awareness of cardiac risk factors and management by Welsh Dentists

Objectives: (1) To determine the knowledge of congenital / acquired cardiac disease and awareness of risk factors for antibiotic prophylaxis among dentists in Wales under current UK guidance (2) To determine their knowledge regarding treatment for patients with pacemakers or implanted defibrillators (3) To determine the educational needs and preferred learning styles to affect changes in cardiac practice. Methods: Self-administered postal questionnaire covering clinical scenarios was sent to 1182 dentists; 993 General Dental Practitioners (GDP), 119 Community Dentists (CDS) and 70 dentists in Hospitals (HDS). Results: 528 questionnaires returned. Cardiac conditions that were risk factors for infective endocarditis in paediatric patients were correctly answered by 46% GDP, 57% CDS and 65% HDS (p<0.001). For adult patients, 62% GDP, 67% CDS and 67% HDS gave correct responses (p<0.05). Knowledge of dental procedures requiring antibiotic prophylaxis for paediatric and adult patients was correctly answered by 52% GDPs, 54% CDS dentists and 56% HDS dentists (ns). Most dentists would not use an ultrasonic scaler in patients with pacemakers or implantable cardiac defibrillator (ICD). Other contraindicated equipment identified included electrocautery devices (34%), apex locators (6%) and electric pulp testers (3%). More dentists in practice and community requested postgraduate courses compared to those in Hospital. Laminated flow diagrams were preferred (52-74%) compared to other educational methods (CD Rom, 13% GDP and email, 12 % HDS). More GDP and CDS dentists would refer to Cardiologists for advice, whilst 46% GDPs would contact General Medical Practitioners; only 4% referred to Hospitals. Conclusions: The majority of dentists are confused by current guidelines for antibiotic prophylaxis. New guidelines should address this. Information should be disseminated regarding dental devices that can be used safely in patients with pacemakers and implantable defibrillators.