Extractions due to dental infections associated with nonfatal MI in elderly men

heart attack

This study was a nested case-control study within the Oslo Study, (a cohort study of the prevention and epidemiology of cardiovascular diseases). The aim was to explore whether dental extractions are associated with myocardial infarction (MI).

The sample consisted of  men with a self-reported history of MI as cases (n = 548) and controls (n = 625) who were selected randomly by 5-year strata to match the age distribution of cases. Reasons for extraction (self-reported) were recorded as periodontal infections (marginal periodontitis) or apical infection of a single tooth, and these were grouped as infection due to extractions. Extractions due to trauma or other causes were grouped as non-infection extractions.

They found that more men with a history of MI had extracted teeth than controls (92.7% versus 88.6%; P = 0.020). The prospective logistic regression analysis predicting nonfatal MI showed strength of association between infection extraction, no extraction, or non-infection extractions combined [odds ratio (OR) = 1.64; 95% confidence interval (CI): 1.24, 2.16] in adjusted analysis and crude analysis (OR = 1.73; 95% CI: 1.34, 2.23). Adjustment was made for known risk factors for MI and periodontitis in 1972 ⁄73, such as systolic blood pressure, smoking, total cholesterol, BMI, and education recorded in the 2000 screening.

They concluded:

Extractions due to dental infections were associated with nonfatal MI in elderly men.

Håheim LL, Olsen I, Rønningen KS. Association between tooth extraction due to infection and myocardial infarction. Community Dent Oral Epidemiol. 2011 May 9.doi: 10.1111/j.1600-0528.2011.00616.x. [Epub ahead of print] PubMed PMID: 21557755.

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. He is a former editor of the Evidence-Based Dentistry Journal, the chief blogger for the Dental Elf website and a past president of the British Association for the Study of Community Dentistry. He has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Retired from the NHS he is currently a part-time senior lecturer at Dundee Dental School.

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