Stroke - Stroke is a leading cause of long-term disabilities. If your stroke caused paralysis of your dominant hand, a family member or caregiver can help with daily dental care. Toothbrushes and floss holders with modified handles are also available. If you wear dentures, your dentures may need to be refashioned or realigned. 

Paralysis of the face and tongue can reduce the ability of saliva to cleanse your mouth, and can make you less aware of oral injuries or food particles in your teeth. Rinsing may be difficult or impossible. Your dentist may suggest that you use a fluoride gel or saliva substitute.
If you take anticoagulant medication, you should talk to your dentist before having any major dental work. Anticoagulants make the blood less likely to clot, which could cause excessive bleeding during surgery. If you need surgery, your dentist will take your medication use into consideration when deciding how to treat you. Usually, routine dental treatment does not require any changes in your medications. Because some of these medicines can thin your blood, bring a copy of your most recent blood tests to your dentist as often as it is available.
 
Congestive Heart Failure - Many medications used to treat congestive heart failure may cause dry mouth (xerostomia). If you are being treated for CHF and have no complications or side effects, there are no special considerations for dental treatment. People with more severe heart failure should not lie down in the dental chair too far because the fluid build-up in their lungs may affect breathing. They should also take it slow when moving from a standing position to the chair, and when standing up from the chair, because they can become dizzy and light-headed easily.
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Pace Maker Implantation - There are no specific oral effects caused by pacemaker implantation. If you have a pacemaker, you should confirm that there are no interactions between electromagnetic devices in your dentist's office and your pacemaker. The chance of any interaction is minimal, and you or your dentist should be able to find out about interactions from your physician or the pacemaker manufacturer. Talk with your physician about possible interactions before visiting the dental office. If there is a chance of interaction, your dentist can take precautions to prevent it. You should avoid elective dental care within the first few weeks after receiving your pacemaker. If you must receive dental care within that time, your dentist should decide if pretreatment are right.  

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