Prevalence of Invasive Dental Procedures and Vascular Events

Objectives: There is ongoing interest in the role of inflammation and endothelial dysfunction as risk factors for vascular events.  The role of invasive dental treatments in creating an inflammatory and endothelial response which transiently increase risk for subsequent vascular event is of continuing clinical concern.  The aim of this study was to determine the prevalence of vascular events (myocardial infarction (MI) and ischemic stroke) and the frequency of preceding invasive dental procedures among community dwelling adults age 65 years and older.

Methods: The Medicare Current Beneficiary Survey (MCBS) is an annual series of nationally representative surveys of Medicare beneficiaries. The survey includes approximately 12,000 participants interviewed three times annually over four consecutive years. Dental visit and health related variables including MI and ischemic stroke were analyzed for community dwelling older Americans likely to seek dental care from 1997-2006.  Invasive dental procedures were defined as cleanings (including periodontal procedures), extractions and endodontic treatment.  Vascular events were identified using ICD-9 codes.

Results: Vascular events ≥ 180 days after survey entry were recorded for 1,382 of  approximately 46,000 MCBS participants.  Of the 1382, 329 (23.8%) reported a dental visit.  Respectively, 109 (7.9%) and 61 (4.4%) underwent invasive dental procedures in the 60 and 30 days prior to a vascular event.

Conclusion: Preliminary MCBS analysis indicates that invasive dental procedures occurred infrequently prior to vascular events and their importance as a risk factor for future ischemic stroke and myocardial infarction needs further study.

Supported by NIH grant DE 14214, MinnCResT 5T32 DE 007288, and the UMSOD Summer Fellowship program.