Stable Angina Dental Safety — ORE Part 1 MCQ

Correct answer: D — Yes; stable angina is manageable in primary dental care with appropriate precautions: stress reduction, ensure GTN is available, short appointments, consider morning scheduling

Stable angina is manageable in primary dental care when appropriate precautions are taken. The key is that the patient's condition is currently stable (no attacks for 1 month despite usual activity). Precautions should include: stress/anxiety reduction (short appointments, morning scheduling, premedication if needed), ensuring GTN is available for the patient, avoiding adrenaline-impregnated cord, using effective local anaesthesia, and planning shorter appointments. Option C is incorrect—not all angina patients require hospital treatment; stable angina managed on medication is suitable for primary care. Option A wrongly implies treatment should be deferred indefinitely; stable angina is chronic and deferral is unnecessary. Option D's 1-year requirement is arbitrary and unsupported by evidence; the stability marker is control on current medications. Option B overstates the need for sedation; appropriate anxiety management and GTN availability are sufficient.

Reference: Providing dental treatment for patients with cardiovascular disease, PubMed 9468935 (1998); SDCEP Antibiotic Prophylaxis Advice for Cardiac Teams; clinicaltrials.gov guidelines on cardiac event dental treatment contraindications, https://pubmed.ncbi.nlm.nih.gov/9468935/