CJ Henley, DMD, PA / San Marco, Jacksonville, Florida
Complex and medically involved dental care in Jacksonville, FL.
Planned around your health, coordinated with your doctors.
Medically complex dental care means planning treatment around your medical conditions and medications, and talking with your physicians when a decision depends on them. Most people on blood thinners or bone medications, or with heart disease, diabetes, a transplant, or cancer treatment, can have dental care safely in our San Marco office; a few situations need a specific plan, and Dr. CJ Henley makes it with you.
- Mostpatients on blood thinners don’t need to stop them for routine dental care5
- Fewheart patients need antibiotics before dental work; stents and pacemakers usually don’t1
- 0.4point average drop in A1c three to four months after gum treatment in people with diabetes15
- 2 hoursfor a first visit, so your medical history gets real time
Physicians and care teams: send a referral through our physician referral page.
What is medically complex dental care?
What medically complex dental care means.
Medically complex dental care is ordinary dentistry planned around how your health and medications affect bleeding, healing, infection risk, anesthesia, and timing. It also covers complex dental cases left by earlier treatment that didn’t go as planned. It usually doesn’t mean a different dentist; it means a careful one who talks to your doctors.
Many of our Jacksonville patients take several medications, have had a heart valve or joint replaced, are preparing for surgery or a transplant, or are living through cancer treatment. Each of those changes a few specific decisions: whether you need antibiotics, whether a blood thinner stays on, whether a tooth should come out before a medication starts, and when treatment fits around your medical care.
Dr. CJ Henley is a general dentist with advanced training in oral medicine, the area of dentistry that diagnoses diseases of the mouth and their links to the rest of the body. He serves on the Head & Neck Tumor Board at Baptist MD Anderson and sees every patient himself. A first visit includes a comprehensive exam and lasts about two hours: roughly an hour with Dr. Henley and an hour with our hygienist.
Who we see
Medical conditions and medications we plan dental care around.
At our Jacksonville office we routinely care for patients on blood thinners and bone medications, and patients with heart conditions, joint replacements, diabetes, organ transplants, cancer treatment, medication dry mouth, and early dementia or limited mobility. Each one changes a few specific decisions, explained below.
Blood thinners
Eliquis, Xarelto, warfarin, Plavix, aspirin. Usually continued; bleeding controlled locally, with your prescriber involved when needed.
Bone medications
Prolia, Fosamax, Boniva, Reclast, Xgeva. Routine care is normal; extractions and implants get a jawbone risk review.
Heart conditions and valves
Only a small group needs antibiotics before dental work; the numbing shot is planned for your heart.
Joint replacements
Hip and knee replacements usually don’t need antibiotics before dental care.
Diabetes
Gum disease and blood sugar affect each other; treating one can help the other.
Transplant and immune suppression
Clearing infection before a transplant, and watching the mouth for medication effects afterward.
Cancer treatment and radiation
Dental care before, during, and after chemotherapy and head and neck radiation.
GLP-1 medications
Ozempic, Wegovy, Mounjaro: what changes for sedation and for your teeth.
Medication dry mouth
Many common medications reduce saliva and raise the risk of decay along the gumline.
Early dementia and limited mobility
Short visits, caregivers welcome, and a wheelchair-accessible treatment room.
Your first visit
Before your first visit: what to bring.
Bring a complete medication list with doses, the timing of your last dose of any blood thinner, the date of your last Prolia, Reclast, or Xgeva dose, any recent lab results such as INR or A1c, your physicians’ names and phone numbers, and any dental clearance form your surgeon or care team gave you.
01 List
Every medication
Prescriptions with doses, plus aspirin, fish oil, and other supplements that affect bleeding.
02 Dates
Key dates
Last blood thinner dose, last bone-drug infusion or injection, and surgery dates for valves or joints.
03 Labs
Recent results
A recent INR if you take warfarin; your latest A1c if you have diabetes.
04 Contacts
Your care team
Names and numbers for your physician, cardiologist, surgeon, or oncologist, and any forms they sent.
Working with your physicians
How we coordinate with your physicians.
When a dental decision depends on your medical care, such as a blood thinner, a bone medication, or the timing of surgery, Dr. Henley will coordinate with the physician who manages it, by phone or with a consult or dental clearance letter. You get a written plan, and your care team gets a summary of what we found and did.
Review
Your medical history, medications, and recent records, before anything is decided.
Consult
A call or letter to your prescriber, cardiologist, surgeon, transplant team, or oncologist when their input changes the plan.
Plan
A written treatment plan in plain language, with the order and timing of each step.
Treat and report
Care timed around your medical treatment, and a letter back to your team.
Physicians in Jacksonville and across Northeast Florida can refer patients through our physician referral page.
Antibiotic premedication
Antibiotics before dental work: heart conditions and joint replacements.
Most people with heart disease or a joint replacement don’t need antibiotics before dental work. The American Heart Association recommends them only for a small group at the highest risk of infective endocarditis, such as people with an artificial heart valve or a past episode of endocarditis.
Antibiotics carry real risks, including allergic reactions, C. difficile infection, and resistance, so the goal is to give them only when the evidence supports it.1,4 The table shows the usual recommendations; your cardiologist or surgeon has the final say for your situation.
| Condition | Antibiotics before dental work? | Source |
|---|---|---|
| Artificial heart valve, including transcatheter valves, or prosthetic material used to repair a valve | ✓ Recommended for procedures involving the gums or root tip | AHA 20211 |
| Previous infective endocarditis | ✓ Recommended | AHA 20211 |
| Certain congenital heart disease (unrepaired cyanotic, or repaired with prosthetic material in the last 6 months or with a residual defect) | ✓ Recommended | AHA 20211 |
| Heart transplant with a leaking, abnormal valve | ✓ Recommended | AHA 20211 |
| Coronary stents, bypass surgery, pacemakers, or defibrillators | ✗ Not routinely recommended | AHA 20211 |
| Heart murmur, mitral valve prolapse, or past rheumatic fever without a valve replacement | ✗ Not routinely recommended | AHA 20211 |
| Hip or knee replacement | ✗ Generally not recommended; decided with your surgeon if you’ve had joint complications | ADA 2015; AAOS 20252,3 |
The American Dental Association’s guideline found no link between dental procedures and joint replacement infections, and does not recommend routine antibiotics for people with prosthetic joints.2 If your orthopedic surgeon still wants you premedicated, the surgeon should prescribe it, and we’re glad to talk with them.4
Blood thinners
Dental care on blood thinners: Eliquis, Xarelto, warfarin, and Plavix.
For most people, cleanings, fillings, crowns, and even simple extractions can be done without stopping a blood thinner, and bleeding is controlled in the mouth. Never stop Eliquis, Xarelto, warfarin, or Plavix on your own; if a change is ever needed, your prescriber decides it with us.
In pooled trials, continuing warfarin at the usual dose didn’t increase clinically significant bleeding after dental surgery compared with stopping it.6 For newer blood thinners (DOACs such as Eliquis and Xarelto), studies found no difference in bleeding between continuing and stopping, and every bleed was controlled with local measures.7 The ADA says that for most patients it isn’t necessary to change anticoagulant or antiplatelet therapy for dental procedures.5
Do
- Take your blood thinner as prescribed unless your prescriber tells you otherwise.
- Bring a recent INR result if you take warfarin; we confirm it with your prescriber before surgery.
- Tell us about aspirin, fish oil, and other supplements.
- Keep firm pressure on gauze after an extraction and follow the written instructions.
Avoid
- Stopping a blood thinner on your own; the risk of a clot or stroke is usually greater than the bleeding risk.
- Stopping Plavix or dual antiplatelet therapy early after a stent; only your cardiologist decides that.5
- Rinsing hard, drinking through a straw, or smoking for the first day after an extraction.
To control bleeding we use pressure, stitches, and dissolving dressings placed in the socket; a tranexamic acid mouthwash has also been shown to help people on warfarin.8 If bleeding hasn’t slowed after 20 to 30 minutes of firm pressure, call us.
Prolia, Fosamax, and MRONJ
Prolia, Fosamax, and other bone medications.
Bone medications such as Prolia (denosumab) and bisphosphonates like Fosamax and Reclast carry a small risk of a jawbone problem called medication-related osteonecrosis of the jaw (MRONJ). The risk is rare at osteoporosis doses and higher at cancer doses. Cleanings, fillings, crowns, and root canals are routine; extractions and implants get a risk review first.
MRONJ means an area of jawbone that becomes exposed and doesn’t heal, usually after a tooth is removed. An ADA expert panel put the best estimate for people taking these drugs for osteoporosis at about 0.1% or lower.9 The risk is higher with the monthly doses used for cancer (Xgeva, Zometa), after several years of treatment, and with gum disease or a poorly fitting denture.10,11
- Best time to see us: before your first dose, so problem teeth are treated while the risk is lowest.
- Before an extraction or implant: we review your dose, how long you’ve taken it, and your other risks, and talk with your prescriber. See dental implants.
- Don’t stop Prolia on your own. Stopping denosumab without a plan can cause rapid bone loss and spine fractures.12 “Drug holidays” from bisphosphonates haven’t been shown to lower jaw risk.9
Read more about MRONJ and dental care on osteoporosis medications.
Heart disease
Heart disease, high blood pressure, and the numbing shot.
Local anesthetic with a small amount of epinephrine is safe for most people with heart disease, and it gives deeper numbness and less bleeding. We use the lowest effective amount, and after a recent heart attack, stroke, or stent, non-urgent dental care is timed with your cardiologist.
A review of 10 trials in people with cardiovascular disease found that low-dose epinephrine in dental anesthetic was safe for some patients and reduced pain and bleeding, though the evidence was low quality.13 Good numbness also matters for your heart: pain and stress raise blood pressure more than a carefully dosed anesthetic does.
Tell us about any heart medications, and bring your nitroglycerin if you’ve been prescribed it. Our page on dental numbness explains how long the numbing shot lasts.
Diabetes
Dental care with diabetes.
Diabetes and gum disease affect each other: high blood sugar makes gum disease worse, and gum disease makes blood sugar harder to control. Treating gum disease lowered A1c by about 0.4 points at three to four months in a Cochrane review.
An international consensus of diabetes and periodontal experts described the relationship as two-way.14 The Cochrane review of 30 studies found an average A1c drop of 0.43 points three to four months after gum treatment, with moderate certainty, and minimal harms.15 That is a real, if modest, benefit.
- Book morning visits and eat and take your medication as usual.
- Bring a snack or glucose tablets, and tell us if you feel low.
- Expect slower healing if your A1c is high; we may time surgery around better control.
- Watch for dry mouth and thrush; see dry mouth caused by diabetes.
Transplant and immune suppression
Organ transplant and immune suppression.
Before an organ or stem cell transplant, transplant teams usually ask for a dental evaluation to find and treat infection. Afterward, anti-rejection medications can cause gum overgrowth, mouth sores, and thrush, so regular checks matter for life.
A 2024 systematic review found a possible link between untreated oral infection and infections after transplant, but no effect on rejection or survival, so the focus is on real sources of infection rather than removing teeth “just in case.”17 Whether your transplant center is in Jacksonville or elsewhere, we send your team a letter describing what we found and what we treated.
After transplant, questions about antibiotics or procedure timing go to your transplant team first. Immune suppression also raises the importance of regular oral cancer screening at every visit.
Cancer treatment
Dental care before and during cancer treatment.
If you’re about to start chemotherapy or head and neck radiation, see a dentist before treatment begins if you can, so infected or failing teeth are treated and extraction sites can heal first. Dr. Henley serves on the Head & Neck Tumor Board at Baptist MD Anderson and will coordinate with your oncology team.
Before head and neck radiation
Dental evaluation, extractions with time to heal, and fluoride trays, following current guideline recommendations for preventing jawbone injury after radiation.19 See dental care for head and neck cancer.
During chemotherapy
Treating infection before your immune system is suppressed, and managing mouth sores and dry mouth. See dental care before and during cancer treatment.
Jaw stiffness after radiation
Exercises and devices for radiation-induced trismus.
After surgery to the upper jaw
Replacing missing tissue with an obturator after maxillectomy.
Dental clearance
Dental clearance before surgery, a transplant, or cancer treatment.
A dental clearance is an exam to find and treat active infection before heart valve surgery, some joint replacements, an organ or stem cell transplant, chemotherapy, head and neck radiation, or IV bone medications. Schedule it as soon as your surgery or treatment is planned, because any extraction needs time to heal first.
01 Exam
Exam and X-rays
A full exam and the X-rays needed to find infection, deep decay, and failing teeth.
02 Treat
Treat what matters
Active infection is treated and hopeless teeth removed, with healing time before your procedure.
03 Letter
Clearance letter
Dr. Henley writes to your surgeon or care team, in Jacksonville or wherever you’re treated: what was found, done, and planned.
04 Follow up
After your procedure
Routine care resumes on a schedule that fits your recovery.
The evidence on how much clearance changes outcomes is limited. In one study of heart valve surgery, a focused exam that treated only real infection led to far fewer extractions than a comprehensive one, with no difference in 90-day survival.18 That’s our approach: treat true infection sources promptly, and don’t remove teeth that aren’t a risk.
Medication side effects
Dry mouth from medications.
More than 50 common medications have strong evidence for causing dry mouth, including some blood pressure medicines, antidepressants, antihistamines, and bladder and Parkinson’s medications. Less saliva means faster decay, especially along the gumline, so we add prevention.
A systematic review found 56 substances with high-level evidence and 50 more with moderate evidence for causing salivary gland dysfunction or dry mouth.20 The more of them you take, the drier your mouth tends to be.
- Prescription-strength fluoride toothpaste or trays, and closer cleaning intervals.
- Saliva substitutes, sugar-free xylitol gum, and sipping water.
- Asking your physician whether an alternative medication would work as well.
See our page on dry mouth, and on burning mouth syndrome if your mouth burns as well.
GLP-1 medications
Ozempic, Wegovy, Mounjaro, and other GLP-1 medications.
GLP-1 medications don’t change routine dental care with local anesthetic. They slow stomach emptying, so if you’re planning oral sedation we follow current anesthesia guidance and your prescriber’s advice about the days before.21 They can also cause dry mouth and reflux that affect your teeth.
Read GLP-1 medications and your teeth for what to watch for and how to protect your enamel.
Older adults and caregivers
Early dementia, Parkinson’s, and limited mobility.
We adapt visits for patients with early dementia, Parkinson’s disease, or limited mobility: shorter morning appointments, a caregiver in the room, simple home-care plans, and a wheelchair-accessible office and treatment room.
Keeping the mouth comfortable and free of infection matters more as daily care gets harder: tooth pain often shows up as poor eating, sleep, or behavior changes in someone who can’t describe it. We favor durable, easy-to-clean solutions and plan treatment while it can still be done comfortably in the chair.
Caregivers are welcome to join visits and to call with questions. If a patient needs care that can only be done in a hospital, we help find the right team in Jacksonville. For coverage questions, see dental insurance after retirement.
Anxiety and sedation
Sedation when you have medical conditions.
Oral sedation is available for anxious patients, case by case, after Dr. Henley reviews your medical history and medications. Some conditions and medication combinations make it unsuitable, and we tell you plainly when that is the case.
Sleep apnea, lung disease, heart conditions, and medications such as opioids, sleep aids, and GLP-1 drugs all factor into the decision. Many anxious patients also do well with longer appointments, clear explanations, and breaks; read how we care for anxious patients.
When we refer. We don’t provide dental treatment under general anesthesia in a hospital operating room. When that, or complex oral surgery, is the safest option, we refer you to an oral and maxillofacial surgeon or hospital dental team and stay involved in your care.
Emergencies
Dental emergencies when you have a medical condition.
A dental infection or bleeding can be more serious when you have a medical condition. Facial swelling with fever, or trouble swallowing or breathing, needs an emergency department; for other urgent dental problems we offer same-day visits during office hours.
you have facial swelling with fever, swelling spreading toward the eye or neck, or bleeding after an extraction that hasn’t slowed after 20 to 30 minutes of firm pressure on a blood thinner. Call us at 904.398.1549; for trouble breathing or swallowing, go to an emergency department. See emergency dental care.
Cost and insurance
Does insurance or Medicare cover dental care for medical conditions?
Dental plans cover exams and many treatments regardless of your medical conditions, usually with yearly limits. Original Medicare generally doesn’t cover routine dental care. We explain the fees for your plan before treatment begins.
We are an out-of-network practice. Some dental plans cover part of exams, cleanings, extractions, and other treatment, often with a frequency limit. We can help you understand how to use your benefits; you are responsible for amounts your plan does not pay. Call our team with your plan details to ask about fees and payment arrangements. If you’re retired or planning to be, read dental insurance after retirement and what patients should know about out-of-network dental insurance.
Medically complex dental care near you
Medically complex dental care in San Marco, for all of Jacksonville.
Patients and physicians across Northeast Florida send medically complex dental cases to our San Marco office because Dr. Henley takes the time to understand the whole medical picture, talks to the doctors involved, and puts the plan in writing. Our office is on Hendricks Avenue, a short drive from Baptist Medical Center Jacksonville. Spanish is spoken in our office.
Read our reviews, learn about our San Marco dental office, or start with our new-patient forms. Patients in Mandarin and Southside can also read our Mandarin and Southside and Baymeadows pages.
San Marco
On Hendricks Avenue, in the neighborhood
Close to home for follow-up visits after an extraction.
Downtown and Southbank
Southbank borders us; Downtown is across the Main Street Bridge
Near the hospitals where many of our patients’ physicians practice.
Riverside, Avondale, and Ortega
Across the St. Johns River on the Fuller Warren Bridge
A short trip for a clearance exam before surgery.
San Jose and Mandarin
North on San Jose Boulevard, which becomes Hendricks Avenue
One road from Mandarin to our door.
Southside and Baymeadows
North on I-95 from Baymeadows Road
An easy drive for a caregiver bringing a parent.
Jacksonville Beach, Neptune Beach, and Atlantic Beach
West on Atlantic Boulevard or Beach Boulevard
Visits planned so one trip covers the exam and the plan.
Ponte Vedra and Nocatee
West on J. Turner Butler Boulevard, then north on I-95
Clearance letters go straight to your surgeon.
Orange Park and Fleming Island
North on US-17 to I-95, then across the Fuller Warren Bridge
Morning appointments booked ahead.
St. Augustine
North on I-95
Worth the drive when your dental and medical care need to be coordinated.
Frequently asked questions
Questions about medically complex dental care.
What is medically complex dental care?
It is dental care planned around your medical conditions and medications: how they affect bleeding, healing, infection risk, anesthesia, and timing. It also includes coordinating with your physicians, and complex dental cases left by earlier treatment. Most of the dentistry is the same; the planning is more careful.
Do I need a special dentist if I have a medical condition?
Usually not. Most people with medical conditions can be treated safely by a general dentist who reviews their history carefully and talks with their physicians. Dr. Henley is a general dentist with advanced training in oral medicine; when a hospital setting or complex oral surgery is safest, we refer and stay involved.
Do I need antibiotics before dental work?
Most people don’t. The American Heart Association recommends antibiotics before dental procedures only for people at the highest risk of infective endocarditis, such as those with an artificial heart valve, a past episode of endocarditis, certain congenital heart disease, or a heart transplant with a leaking valve.
I had a hip or knee replacement. Do I need antibiotics before a cleaning?
Generally not. The American Dental Association found no link between dental procedures and joint replacement infections and doesn’t recommend routine antibiotics. If you’ve had complications with your joint, we decide with your orthopedic surgeon, who should prescribe any antibiotic.
I have a heart stent or pacemaker. Do I need premedication?
No, not for the stent or pacemaker alone. The American Heart Association doesn’t recommend antibiotics before dental work for stents, bypass surgery, pacemakers, defibrillators, heart murmurs, or mitral valve prolapse. Don’t stop Plavix or other antiplatelet medicine after a stent unless your cardiologist says so.
Should I stop Eliquis, Xarelto, or warfarin before a tooth extraction?
Usually not, and never on your own. Studies found continuing these medications didn’t meaningfully increase bleeding after extractions, and bleeding was controlled in the mouth. If your situation calls for a change, your prescriber decides it with us. Bring a recent INR if you take warfarin.
I take Plavix or aspirin after a stent. Is dental work safe?
Yes. Cleanings, fillings, and most extractions can be done while you take Plavix or aspirin, with local measures to control bleeding. Stopping antiplatelet medicine early after a stent can cause a dangerous clot, so only your cardiologist should change it.
I’m on Prolia or Fosamax. Can I have a tooth pulled or get an implant?
Often, yes, after a risk review. At osteoporosis doses the risk of jawbone problems (MRONJ) is rare, about 0.1% or lower; it is higher at cancer doses and after several years of treatment. We review your dose, duration, and gum health, and talk with your prescriber before an extraction or implant.
Should I stop Prolia or take a “drug holiday” before dental work?
Not on your own. Stopping Prolia without a plan can cause rapid bone loss and spine fractures, and drug holidays from bisphosphonates haven’t been shown to lower jaw risk. Any change to your bone medication should be decided by the physician who prescribes it.
Is the numbing shot with epinephrine safe if I have heart disease or high blood pressure?
For most people, yes. Low-dose epinephrine in dental anesthetic was safe in studies of people with heart disease and gave better numbness and less bleeding. We use the lowest effective amount, and after a recent heart attack, stroke, or stent we time non-urgent care with your cardiologist.
Can treating gum disease help my diabetes?
It can help modestly. A Cochrane review found gum treatment lowered A1c by about 0.4 points three to four months later, with moderate certainty. Gum disease and diabetes affect each other, so treating your gums is part of good diabetes care, not a replacement for it.
What is a dental clearance, and how far ahead should I schedule it?
A dental clearance is an exam to find and treat active infection before heart valve surgery, some joint replacements, a transplant, chemotherapy, head and neck radiation, or IV bone medications. Schedule it as soon as your procedure is planned, because any extraction needs time to heal before your procedure.
Will you send a letter to my surgeon, cardiologist, or transplant team?
Yes. Dr. Henley writes consult and dental clearance letters describing what he found, what was treated, and what is planned, and he calls your physician when a decision depends on them. Bring their names and contact information, and any form they gave you.
I’m waiting for an organ transplant. What dental care do I need?
Most transplant teams ask for a dental evaluation to find and treat infection before the transplant. We treat real infection sources, send your team a letter, and keep you on regular checkups afterward, because anti-rejection medications can cause gum overgrowth, sores, and thrush.
I’m starting chemotherapy or radiation. When should I see a dentist?
As soon as your treatment is planned, before it begins if possible, so infection can be treated and any extraction can heal first. For head and neck radiation this is especially important. Dr. Henley serves on the Head & Neck Tumor Board at Baptist MD Anderson and coordinates with your oncology team.
My medications give me dry mouth. What can I do?
Sip water, use sugar-free xylitol gum or saliva substitutes, and use a prescription-strength fluoride toothpaste to protect against decay. Ask your physician whether a different medication would work as well. More than 50 medications have strong evidence for causing dry mouth, so it is very common.
Is dental work or sedation safe on Ozempic or another GLP-1 medication?
Routine dental care with local anesthetic is fine. Because GLP-1 medications slow stomach emptying, oral sedation needs a plan that follows current anesthesia guidance and your prescriber’s advice for the days before. Tell us about the medication when you book.
Can you treat a parent with early dementia or limited mobility? Is the office wheelchair accessible?
Yes. We offer shorter morning visits, welcome caregivers in the room, keep home-care plans simple, and our office and a treatment room are wheelchair accessible. If a patient needs care that can only be done in a hospital, we help find the right team.
Does treating my teeth prevent heart disease or other illnesses?
Not proven. Gum disease is associated with heart disease and other conditions, but the American Heart Association found no evidence that treating it prevents heart disease. Oral health belongs in your overall care, and treating your own dental problems is worthwhile on its own merits.
Can I have sedation if I have medical conditions?
Often, yes. Oral sedation is available case by case after Dr. Henley reviews your medical history and medications. Sleep apnea, lung disease, some heart conditions, and certain medications can make it unsuitable, and we tell you plainly if so. We don’t provide general anesthesia.
Does insurance or Medicare cover dental care for medical conditions?
Dental plans cover exams and many treatments, usually with yearly limits, and original Medicare generally doesn’t cover routine dental care. We are an out-of-network practice and can help you understand how to use your benefits. Call our team with your plan details to ask about fees before scheduling.
Where can I find a dentist for medically complex patients in Jacksonville?
CJ Henley, DMD, PA provides medically complex dental care at 3675 Hendricks Avenue, Jacksonville, FL 32207, in San Marco. Patients come from Mandarin, Southside, Riverside, the Beaches, Ponte Vedra, Orange Park, and St. Augustine. Call 904.398.1549, and bring your medication list and your physicians’ contact information.
More reading: Osteoporosis medications and your dental health · GLP-1 medications and your teeth · Dental FAQ
Your next step
Bring your medication list. We’ll take it from there.
Whether you need a dental clearance before surgery, a plan for an extraction on a blood thinner, or simply a careful dentist who will talk to your doctors, start with a comprehensive exam at our Jacksonville office. If you have swelling, bleeding, or pain now, see emergency dental care.
CJ Henley, DMD, PA3675 Hendricks Avenue
Jacksonville, FL 32207
Prefer a nonurgent text? 904.762.5616 is our practice on-call and text line. Please don’t send sensitive health information by text, and call for anything urgent.
Related pages
Sources
- Wilson WR, Gewitz M, Lockhart PB, et al. Prevention of viridans group streptococcal infective endocarditis: a scientific statement from the American Heart Association. Circulation. 2021;143(20):e963-e978.
- Sollecito TP, Abt E, Lockhart PB, et al. The use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints: evidence-based clinical practice guideline for dental practitioners. J Am Dent Assoc. 2015;146(1):11-16.e8.
- Fillingham YA, Hannon CP, Jevsevar DS, et al. AAOS clinical practice guideline summary: prevention of total hip and knee arthroplasty periprosthetic joint infection in patients undergoing dental procedures. J Am Acad Orthop Surg. 2025;33(21):e1260-e1267.
- American Dental Association. Oral Health Topics: Antibiotic prophylaxis prior to dental procedures.
- American Dental Association. Oral Health Topics: Oral anticoagulant and antiplatelet medications and dental procedures.
- Nematullah A, Alabousi A, Blanas N, Douketis JD, Sutherland SE. Dental surgery for patients on anticoagulant therapy with warfarin: a systematic review and meta-analysis. J Can Dent Assoc. 2009;75(1):41.
- Manfredi M, Dave B, Percudani D, et al. World Workshop on Oral Medicine VII: direct anticoagulant agents management for invasive oral procedures: a systematic review and meta-analysis. Oral Dis. 2019;25 Suppl 1:157-173.
- Engelen ET, Schutgens RE, Mauser-Bunschoten EP, van Es RJ, van Galen KP. Antifibrinolytic therapy for preventing oral bleeding in people on anticoagulants undergoing minor oral surgery or dental extractions. Cochrane Database Syst Rev. 2018;7:CD012293.
- Hellstein JW, Adler RA, Edwards B, et al. Managing the care of patients receiving antiresorptive therapy for prevention and treatment of osteoporosis: executive summary of recommendations from the American Dental Association Council on Scientific Affairs. J Am Dent Assoc. 2011;142(11):1243-51.
- Ruggiero SL, Dodson TB, Aghaloo T, Carlson ER, Ward BB, Kademani D. American Association of Oral and Maxillofacial Surgeons’ position paper on medication-related osteonecrosis of the jaws: 2022 update. J Oral Maxillofac Surg. 2022;80(5):920-943.
- American Dental Association. Oral Health Topics: Osteoporosis medications and medication-related osteonecrosis of the jaw.
- Tsourdi E, Zillikens MC, Meier C, et al. Fracture risk and management of discontinuation of denosumab therapy: a systematic review and position statement by ECTS. J Clin Endocrinol Metab. Published online October 26, 2020.
- Guimaraes CC, Lopes LC, Bergamaschi CC, et al. Local anaesthetics combined with vasoconstrictors in patients with cardiovascular disease undergoing dental procedures: systematic review and meta-analysis. BMJ Open. 2021;11(7):e044357.
- Sanz M, Ceriello A, Buysschaert M, et al. Scientific evidence on the links between periodontal diseases and diabetes: consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International Diabetes Federation and the European Federation of Periodontology. J Clin Periodontol. 2018;45(2):138-149.
- Simpson TC, Clarkson JE, Worthington HV, et al. Treatment of periodontitis for glycaemic control in people with diabetes mellitus. Cochrane Database Syst Rev. 2022;4:CD004714.
- Lockhart PB, Bolger AF, Papapanou PN, et al. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association? A scientific statement from the American Heart Association. Circulation. 2012;125(20):2520-44.
- Olsson J, Hunfjörd S, Braun O, et al. Impact of oral infection on organ transplantation: a systematic review. J Evid Based Dent Pract. 2024;24(4):102035.
- Rao NR, Treister N, Axtell A, et al. Preoperative dental screening prior to cardiac valve surgery and 90-day postoperative mortality. J Card Surg. 2020;35(11):2995-3003.
- Peterson DE, Koyfman SA, Yarom N, et al. Prevention and management of osteoradionecrosis in patients with head and neck cancer treated with radiation therapy: ISOO-MASCC-ASCO guideline. J Clin Oncol. 2024;42(16):1975-1996.
- Wolff A, Joshi RK, Ekström J, et al. A guide to medications inducing salivary gland dysfunction, xerostomia, and subjective sialorrhea: a systematic review sponsored by the World Workshop on Oral Medicine VI. Drugs R D. 2017;17(1):1-28.
- Joshi GP, LaMasters T, Kindel TL. Preprocedure care of patients on glucagon-like peptide-1 receptor agonists: a multisociety clinical practice guidance. Anesthesiology. 2024;141(6):1208-1209.
Complex & Medically Involved Care
Not every dental situation is routine. Some patients require care that involves more detailed diagnosis, careful planning, and coordination with other healthcare providers.
Complex and medically involved dental care refers to situations where oral health is affected by medical conditions, prior surgery, cancer treatment, trauma, or previous dental treatment that did not go as planned. These cases often require a broader view one that considers anatomy, healing capacity, function, and long-term outcomes.
Examples of complex or medically involved care may include:
Dental rehabilitation following head and neck cancer surgery
Maxillectomy defects requiring prosthetic obturation
Patients undergoing or recovering from radiation or chemotherapy
Management of complications from prior dental treatment
Patients with significant medical histories that affect healing or treatment planning
In these situations, successful care depends on careful diagnosis, thoughtful sequencing, and collaboration. Treatment is rarely rushed, and decisions are made with long-term function, comfort, and stability in mind.
At CJ Henley, DMD, PA, we approach medically involved care with the same philosophy that guides all of our treatment: listen carefully, evaluate thoroughly, and plan intentionally. When appropriate, we work closely with surgeons, oncologists, physicians, and speech-language pathologists to ensure care is coordinated and aligned with each patient’s overall health.
Taking a GLP-1 medication? Read our guide to GLP-1 medications and your teeth, and tell us about your medications at your appointment.
If your dental needs feel more complex, or if prior treatment has left you uncertain about next steps, we invite you to schedule a consultation. Our goal is to help you understand your situation clearly and move forward with a plan that makes sense for you.
Do I need antibiotics before dental treatment?
Most patients do not need preventive antibiotics for routine dental care. Certain high-risk heart conditions may require them for specified procedures. A joint replacement alone generally does not mean automatic premedication. Bring your current medical history, medications, and any specialist instructions so the dentist and medical team can resolve the question before treatment. Your medical history is reviewed at every comprehensive exam.
Do not start, stop, or change prescribed antibiotics based on a general article. Recommendations depend on your condition and the planned procedure. See the ADA guidance on antibiotic prophylaxis.
Does treating my teeth prevent other medical diseases?
Oral health belongs in your overall care plan, but a research association does not prove that dental treatment prevents heart disease, dementia, or another illness. The useful next step is identifying and treating your own dental problems while coordinating with your medical clinicians.
Patients receiving cancer therapy can read our guide to dental care during cancer treatment. Medical teams can use our physician referral information to coordinate care in Jacksonville.