Could dentists damage your heart while fixing your teeth?

I found out last week that some of my friends have been avoiding seeing a dentist for years—15 years in one case. The idea of visiting a dentist makes lots of people anxious, often because they expect that treatment will be painful. The cost of dental treatment is also an issue for many people.

A new study has found another reason to be concerned about dental surgery. After invasive procedures, like a tooth extraction, there's a slightly higher risk of a heart attack or stroke in the following month.

The researchers looked at data from Medicaid claims, which included 1,152 people who'd had a heart attack or stroke, and who'd also had invasive dental work. Among these people, 40 had had heart attacks or strokes in the first month after dental surgery, which dropped to 29 in the second month, 30 in the third month, and 25 in the fourth month. There were 53 heart attacks and strokes in the fifth and sixth months combined.

After adjusting the figures to take into account people's ages, the researchers figured out that the risk of a heart attack or stroke in the month after dental surgery was one-and-a-half times the person's normal risk. The risk dropped back to normal after six months.

There's another possibility, too. Dentists sometimes tell people to stop taking aspirin before having dental surgery, as aspirin keeps the blood from clotting so easily, which can lead to problems with bleeding. However, the same anti-clotting action also helps to prevent heart problems and strokes. So, changes in aspirin use could have been the reason for some of the extra heart attacks and strokes.

Was my friend right to avoid the dentist for so long then? Well, no. The researchers only looked at invasive dental surgery—procedures likely to allow bacteria to enter the bloodstream or cause inflammation. So, there's no need to worry about minor procedures like fillings. Even with more major dental surgery, the risk to your heart is likely to be small, especially if you're young and in good health. However, if you're worried about your cardiovascular health, it may be worth talking to your doctor to make sure you're doing everything you can to prevent problems.

What you need to know. If your dentist suggests stopping aspirin or a similar drug before dental surgery, check that it really is essential. You can reduce your chance of needing dental surgery by having regular checkups, brushing and flossing, and avoiding sugary foods and beverages.

—Philip Wilson, patient editor, BMJ Group

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Concerned about heart disease? Take a look at our 11 tips for keeping your heart healthy.