"This is the initial sign of increased risk for heart attack or stroke after a dental procedure," co-author Dr. Francesco D'Aiuto, a dentist also researcher at University College London Eastman Dental Institute, told Reuters Health. "This is not to say that this will occur with every dental procedure, but we are saying we need to look more into it."

It's hard to know exactly what's going on, because the researchers didn't have access to information about the drugs patients were taking around the time of their operation. If they cut down on certain medications, for example, that alone could have upped their chances of suffering a heart attack or a stroke.

Still, because these conditions affect more than one million people in the U.S., the increased risk could be significant.

According to the study, heart attack and stroke occurred more often in the first four weeks after the operation than any other time during or after the recovery stage.

The researchers tapped into Medicaid data provided by GlaxoSmithKline -- which makes drugs to treat heart disease and stroke -- on a group of U.S. Medicaid patients receiving dental work, with simple procedures like removing a tooth.

D'Aiuto explained that heart attack and stroke are linked to bacterial infections and inflammation after other invasive treatments, likely because inflammation can damage the walls of arteries and contribute to the formation of plaques that clog arteries.

The authors, writing in the Annals of Internal Medicine, said that this led them to surprise about the role of dental surgery as well.

They couldn't find a lot of suitable patients to check, however. The Medicaid claims database includes information for close to 10 million people, but there were only 1,150 people who had an invasive dental procedure and a heart attack or stroke in the 4-year period they focused on.

In that population, 40 cases of heart attack or stroke occurred in the first four weeks after dental work -- one and a partly times the baseline rate.

Dr. Howard Weitz, a cardiologist at Thomas Jefferson University in Philadelphia and co-author of an editorial about the study, told Reuters Health that the study was not designed to verify if dental surgery causes heart problems, only to see if they are associated with each other.

He also said previous research shows that errors in recording information in a database like the Medicaid one are fairly general.

Even when it's right, Medicaid information does not include the use of aspirin and other over-the-counter medications that help to prevent heart disease.


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