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Recent epidemiologic studies have demonstrated an association, but not a causal relationship, between heart disease and dental/periodontal diseases because of periodontal pathogens and certain serologic proteins found in the gingival sulcus that cause systemic inflammation.

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Antibiotic prophylaxis before certain dental procedures is recommended for persons with cardiac valvular abnormalities at risk for developing subacute bacterial endocarditis. Recent modification of the antibiotic recommendations simplified and clarified the regimen to reduce overuse of antibiotics, potential adverse effects, and drug resistance. Dental procedures for which endocarditis prophylaxis is reasonable are events that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa.

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Patients on cardiovascular medications can have hyposalivation, which is deleterious to oral and pharyngeal health and function. Specific etiologies include classes of medications such as diuretics, calcium channel blockers, and angiotensin-converting enzyme inhibitors.

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Early detection of oral cancer is critical because patients with early-stage tumors have considerably better survival rates than those with late-stage cancers that have already spread to regional tissues and the lymphatic system.

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Head and neck cancer patients must undergo preoperative dental evaluation and treatment before definitive therapy so as to remove oral pathology (e.g., dental caries, periodontal disease, nonrestorable teeth) before developing the common oral sequelae of surgery, chemotherapy, and radiotherapy.

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The motor, sensory, and cognitive alterations that accompany cerebrovascular diseases have deleterious effects on oral health and function. A cerebrovascular accident (CVA, or stroke) can cause permanent oral sensory and motor deficits, resulting in poor tongue function and lip seal, difficulty eating and drinking, impaired use of dentures, and visuospatial problems with adverse social and psychologic consequences.

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Most patients on anticoagulation requiring simple oral surgical procedures, if local hemostatic and conservative surgical techniques are used, do not need to discontinue their anticoagulation regimen.

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Patients who control their diabetes have fewer oral health problems than those with poorly controlled diabetes. There is an association between severe periodontitis and an increased risk of poor glycemic control.

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Sjögren’s syndrome (SS), a systemic autoimmune disorder associated with inflammation of epithelial tissues, is the most common medical disorder associated with xerostomia and salivary dysfunction.

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Herpes simplex virus (HSV-1) and varicella-zoster virus (VZV) are the most common viral infections in the oral-facial region. They can present as herpes labialis or primary herpetic gingivostomatitis (HSV-1) or acute, painful, oral-facial lesions (VZV).

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The most frequent oral fungal infection is caused by Candida albicans. The overgrowth of C. albicans in the oral-pharyngeal region has many etiologies: endocrine disorders (e.g., diabetes), immunosuppression, nutritional deficiencies, medications (particularly antibiotics and long-term immunosuppressants), salivary gland hypofunction, removable dental prostheses, and poor oral and denture hygiene.

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Lichen planus is a chronic, mucocutaneous, autoimmune disorder that can be precipitated by a number of conditions such as genetic predisposition, emotional stress, or drug, food, or dental material hypersensitivity.