Invasive Dental Treatment and Risk for Vascular Events: Have We Bitten Off More Than We Can Chew?

Weitz, Howard H.; Merli, G

doi:10.7326/0003-4819-153-8-201010190-00013

Cited by 4 publications

(1 citation statement)

References 14 publications

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“…Some evidence suggests that invasive dental treatments (IDTs) could be associated with MI/IS (Minassian et al 2010; Haheim et al 2011). However, this association is still controversial (Weitz and Merli 2010; Matthews 2011; Nordendahl et al 2018). Bacteria resident in the oral cavity may gain access to the bloodstream through damaged tissue caused by IDTs, and their traveling through the circulation could induce vascular dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Risk of Myocardial Infarction and Ischemic Stroke after Dental Treatments

et al. 2018

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The association between invasive dental treatments (IDTs) and a short-term risk of myocardial infarction (MI) and ischemic stroke (IS) remains controversial. Bacterial dissemination from the oral cavity and systemic inflammation linked to IDT can induce a state of acute vascular dysfunction. The aim of study is to investigate the relation of IDTs to MI and IS by using case-only study designs to analyze data from a large Taiwanese cohort. A nationwide population-based study was undertaken by using the case-crossover and self-controlled case series design to analyze the Taiwanese National Health Care Claim database. Conditional logistic regression model and conditional Poisson regression model were used to estimate the risks of MI/IS. In addition, we used burn patients as negative controls to explore the potential effect of residual confounding. In total, 123,819 MI patients and 327,179 IS patients in the case-crossover design and 117,655 MI patients and 298,757 IS patients were included in the self-controlled case series design. Results from both study designs showed that the risk of MI within the first 24 wk after IDT was not significantly different from or close to unity except for a modest risk during the first week for patients without other comorbidities (odds ratios [95% confidence intervals] of 1.31 [1.08–1.58] and 1.15 [1.01–1.31] for 3 d and 7 d, respectively). We also observed no association between IDTs and IS, or the risk ratio was close to unity. IDTs did not appear to be associated with a transient risk of MI and IS in the Taiwanese population, with consistent findings from both case-only study designs. However, we cannot exclude that dental infections and diseases may yield a long-term risk of MI and IS.

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Section: Introductionmentioning

confidence: 99%

Risk of Myocardial Infarction and Ischemic Stroke after Dental Treatments

et al. 2018

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Understanding Systemic Inflammation, Oral Hygiene, and Cardiovascular Disease

Vaishnava

Narayan

Fuster

2011

The American Journal of Medicine

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Evaluation of cardiac risk in dental patients

et al. 2018

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Patients with cardiac disease, cardiac symptoms and related co-morbidities are increasingly being encountered in dental practice. Current methods of medical risk assessment can however be problematic. This paper represents a multi-speciality consensus on how to identify patients that may be more at risk of an adverse cardiac event occurring perio-operatively i.e. during or in the first few weeks after a dental procedure. Drawing on guidelines for surgery and the available literature, we present on an algorithm which aims to inform dental practitioners' decisions about which patients can be managed in primary care and which should be considered for assessment by a dental specialist together with a methodology thereof.

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Invasive Dental Treatment and Risk for Vascular Events: Have We Bitten Off More Than We Can Chew?

Cited by 4 publications

References 14 publications

Risk of Myocardial Infarction and Ischemic Stroke after Dental Treatments

Risk of Myocardial Infarction and Ischemic Stroke after Dental Treatments

Understanding Systemic Inflammation, Oral Hygiene, and Cardiovascular Disease

Evaluation of cardiac risk in dental patients

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