Invasive Dental Treatment and Risk for Stroke or MI

Studies have suggested that intensive periodontal treatment leads to endothelial dysfunction and elevated markers of inflammation. Whether these changes raise risk for vascular events is not known. Using U.S. Medicaid claims data, researchers evaluated risk for adverse vascular events during the 24 weeks after invasive dental work. Individual patients served as their own controls (rates of vascular events were assessed during periods with and without exposure to invasive dental procedures). The final sample consisted of 1152 patients (41% with histories of coronary artery disease [CAD]) who were hospitalized for ischemic stroke or myocardial infarction (MI) and had undergone invasive dental procedures.

Risk for ischemic stroke or MI was transiently increased during the first 4 weeks after an invasive dental procedure (incidence ratio, 1.5) but not during weeks 5 through 24, relative to baseline (periods more than 24 weeks after any invasive dental procedure). In sensitivity analyses, the findings did not change when analysis was limited to patients with no histories of having filled antiplatelet drug prescriptions, or when patients with recently diagnosed diabetes or CAD were excluded.