MONDAY, Oct. 18 (HealthDay News) -- Invasive dental procedures
designed to treat gum inflammation may raise the risk for heart
attack and stroke, researchers say.
But the increase appears to be slight and short-term, the study
"I don't want to downplay this entirely, because we saw a genuine rise in cardiovascular risk in the period just after dental work was done among patients undergoing invasive treatment," said study co-author Liam Smeeth, a professor of clinical epidemiology at the London School of Hygiene and Tropical Medicine in England. "But the overall risk is quite small and endures for only a very brief period."
Smeeth and his colleagues published their findings in the Oct.
19 issue of the
Annals of Internal Medicine.
Previous research has linked common and chronic low-grade dental
infections to inflammatory processes that elevate the risk for
strokes and heart attacks, the authors pointed out.
But whether treatment for those infections raises a similar risk
had not been explored, said the authors who set out to study the
potential link between the two.
The team analyzed U.S. Medicaid records for nearly 1,200
patients who had undergone invasive dental treatments and had also
experienced a stroke or a heart attack between 2002 and 2006.
The patients' median age was 67, and invasive dental procedures
were characterized as those with the potential to cause an
inflammatory response, such as periodontal therapy and tooth
Nearly three-quarters of the patients had undergone a single
dental procedure, nearly all of them (89 percent) tooth
extractions. About one-quarter had had two to four dental
treatments, with 57 days, on average, between each procedure.
About 4 percent of the patients died during hospitalization.
Even after taking into consideration a history of diabetes, high
blood pressure and/or coronary heart disease, the team observed a
significant but slight increase in heart-related events during the
month following a dental treatment, primarily because of an
apparent short-term rise in heart attack risk. Stroke risk appeared
to rise less significantly than heart attack risk.
However, no patient suffered a cardiovascular event on the day
of treatment, and the apparent increased risk for heart problems
dissipated within six months, the researchers noted.
Such "transient" cardiovascular concerns are generally minimal,
do not outweigh the long-term cardiovascular benefits of invasive
dental treatment, and should not deter patients from getting the
dental care they need, the authors concluded.
In an editorial in the same journal, Dr. Howard Weitz of the
Jefferson Heart Institute and Dr. Geno Merli of the Jefferson
Vascular Center, both in Philadelphia, noted that it is too early
to say that routine dental care should be altered in any way based
on the current findings.
For one thing, they said the jury is still out on how clear a
connection actually exists between periodontal disease and
cardiovascular illness in the first place. And they theorized that
much of the observed treatment-related risk might actually stem
from a common pre-procedure practice, namely that patients who
routinely take aspirin to lower their heart risk stop taking the
medication before undergoing dental surgery.
With millions of Americans on an ongoing aspirin regimen, Weitz
and Merli said this angle requires further exploration.
Anthony Iacopino a prosthodontist and dean of the University of
Manitoba's school of dentistry in Canada, said he was not surprised
that dental treatment may entail some cardiovascular risk. But he
agreed that the benefits of treatment far exceed the risks.
"Periodontal disease is an infection, and bacteria gets into the bloodstream as a result," he noted. "This happens at a low level at rest, and even more so when a person eats and chews, and perhaps even more so when he or she has dental treatment.
"But there is a very big difference between a temporarily high level of bacterial exposure during one or two treatment sessions and years and years of walking around with untreated periodontal disease," stressed Iacopino. "Clearly, whatever exposure a patient goes through during dental treatment, it's worth it in the long run."
For more on periodontal disease, visit the
American Academy of Periodontology.
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