Invasive dental treatment and acute vascular events: A systematic review and meta‐analysis

Abstract

Background Acute infection/inflammation increases the risk of acute vascular events (AVEs). Invasive dental treatments (IDTs) trigger short‐term acute inflammation. Purpose The aim of this work is to critically appraise the evidence linking IDTs and AVEs. Data Sources Six bibliographical databases were searched up to 31 August 2021. A systematic review following PRISMA guidelines was performed. Study Selection Intervention and observational studies reporting any AVEs following IDT were included. Data Extraction Two reviewers independently extracted data and rated the quality of studies. Data were pooled using fixed‐effect, inverse variance weights analysis. Risk of Bias Risk of bias was assessed by the Newcastle–Ottawa Quality Assessment Scale for observational studies and the Cochrane Handbook–Rob 2.0 for randomized controlled trials. Data Synthesis In 3 out of 16 clinical studies, a total of 533,175 participants, 124,344 myocardial infarctions, and 327,804 ischaemic strokes were reported. Meta‐analysis confirmed that IDT did not increase incidence ratios (IR) for combined vascular events either at 1‐4 weeks (IR of 1.02, 95% CIs: 0.92 to 1.13) and at 5‐8 weeks (IR of 1.04, 95% CIs: 0.97 to1.10) after treatment. Limitations A high level of heterogeneity (study designs and time point assessments) was found. Conclusion Patients who received IDT exhibited no substantial increase in vascular risk over 8 weeks post treatment.

Treatment of gingivitis is associated with reduction of systemic inflammation and improvement of oral health‐related quality of life: A randomized clinical trial

“…Supposedly, a reduction of the local inflammation, which is characterized by the production of local ILs that are usually elevated during gingivitis (Andriankaja et al, 2009; Leite et al, 2022), may ultimately diminish the hepatic trigger for the production of systemic inflammation. Moreover, reduction of bacteraemia has been quoted as one of the reasons for the reduction of post‐operative systemic inflammation in periodontitis (Luthra et al, 2022). In subjects with gingivitis, toothbrushing determines bacteraemia in a dose‐dependent fashion with plaque accumulation and gingival inflammation (Tomás et al, 2012).…”

Major relationships of tooth extraction in patients with cardiovascular diseases: a concise systematic review

“…In those with severe risk, it is recommended that the physician in charge request anesthetics without vasoconstrictors avoid undesirable complications, such as tachycardia and even cardiac arrest. This brings with it some disadvantages during the treatment because, in addition to decreasing the time of action of the drug, due to the rapid leakage of the anesthetic components into the bloodstream, it provides a potential increase in systemic toxicity [1][2][3].…”

“…The risk of an acute cardiovascular event increases considerably during periods of acute infection or influenza season. Chronic dental infections have been associated with systemic inflammation, endothelial dysfunction, and increased incidence of future cardiovascular events [2].…”

Periodontitis, Dental Procedures, and Young-Onset Cryptogenic Stroke

“…Invasive dental treatments trigger a short-term acute-phase response (D'Aiuto et al 2007), which may result in an increased risk for acute cardiovascular events (Elkind et al 2020). In a recent systematic review, however, invasive dental treatments were not significantly associated with an increased risk of ischemic stroke, but the analyses were limited by a high level of heterogeneity in the published studies (Luthra et al 2022).…”