Invasive Dental Treatments May Increase Risk of Heart Attack and Stroke Short-Term


Does invasive dental treatments increase the risk of heart attack and stroke? A new study suggests invasive dental treatments do for as much as six months after the treatments.

The study has been in the October 19 issue of the Annals of Internal Medicine. The study suggests that the risk of heart attacks and strokes increases after invasive dental treatments.

Caroline Minassian, MSc, of the London School of Hygiene and Tropical Medicine, and colleagues conducted a retrospective review of Medicaid claims data of 32,060 adults who had a heart attack or stroke. The researchers then looked to see which of these patients had undergone any invasive dental procedures. A total of 1175 patients were found who had invasive dental treatment prior to a primary hospital discharge diagnosis of ischemic stroke (n = 650) or myocardial infarction (n = 525) from 2002 to 2006.

The most common invasive dental procedure was the surgical removal of teeth, but included treatment of periodontal gum disease and root canals.

The incidence of ischemic stroke and myocardial infarction in periods immediately after invasive dental treatment was compared with the incidence in all other observed time periods.

The researches found the risk of having a heart attack or stroke after invasive dental treatment increased in the first 4 weeks(incidence ratio, 1.50) and gradually returned to the baseline rate within 6 months. This increased risk remained after exclusion of persons with diabetes, hypertension, or coronary artery disease or persons with prescriptions for antiplatelet or salicylate drugs before treatment.


More than half of the heart attack and strokes seen in the study occurred in women, and 30% in people who were younger than 50.

Dental disease has been linked to an increase in heart disease thought to be due to the increased inflammatory response of the body to the periodontal disease, a chronic bacterial infection of the gums.

The researchers stated invasive dental procedures, particularly treatment for periodontal disease, may increase the risk of heart attack and stroke because they boost inflammation in the body as it responds to bacteria entering the bloodstream following surgery.

"These findings provide further evidence to support the link between acute inflammation and the risk for vascular events," conclude the study researchers, who were led by. "The short-lived adverse effects are nevertheless likely to be outweighed by long-term benefits of invasive dental work."

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Invasive Dental Treatment and Risk for Vascular Events: A Self-Controlled Case Series; Minassian, C, D’Aiuto, F, Hingorani, A.D., Smeeth, L; Ann Intern Med October 19, 2010 153:499-506

Invasive Dental Treatment and Risk for Vascular Events: Have We Bitten Off More Than We Can Chew?; Weitz, H, Merli, G; Ann Intern Med October 19, 2010 153:542-543