RecruitingNot ApplicableNCT07511673

The Study Tests if Preoperative Dental Screening is Superior to no Preoperative Dental Screening in Improving the Outcome of Patients Undergoing Surgical Cardiac Valve Replacement or Transcatheter Cardiac Valve Implantation.

SMILE: A Randomized Trial of Preoperative Dental Screening for the Prevention of Endocarditis, Reoperation or Death in Patients Undergoing Surgical or Transcatheter Cardiac Valve Intervention.


Sponsor

Region Skane

Enrollment

1,300 participants

Start Date

May 6, 2026

Study Type

INTERVENTIONAL

Conditions

Summary

This randomized, multicenter, open-label trial evaluates whether preoperative dental screening improves outcomes in patients undergoing surgical or transcatheter cardiac valve intervention. Participants are randomized 1:1 to preoperative dental screening or no screening. The primary outcome is time to first occurrence of all-cause death, redo-intervention of the index valve, or definite infective endocarditis within 2 years. The study uses registry-based follow-up to ensure complete outcome ascertainment.


Eligibility

Min Age: 18 Years

Inclusion Criteria3

  • Age ≥18 years
  • Accepted for cardiac valve intervention
  • Able to provide informed consent

Exclusion Criteria6

  • Previous or ongoing infective endocarditis
  • Urgent surgery
  • Pain from loose tooth/teeth
  • Immunosuppressive therapy (excluding corticosteroids)
  • Inability to provide informed consent
  • Expected loss to follow-up

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Interventions

OTHERPreoperative dental screening

Dental examination prior to valve intervention; treatment performed if indicated.

OTHERNo preoperative dental screening

No routine dental screening prior to valve intervention.


Locations(5)

Sahlgrenska University Hospital

Gothenburg, Sweden

Linköping University Hospital

Linköping, Sweden

Skane University Hospital

Lund, Sweden

Örebro University Hospital

Örebro, Sweden

Karolinska University Hospital

Stockholm, Sweden

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NCT07511673


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