Removing Teeth Before Heart Surgery Poses Unexpected Risks

Removing infected teeth right before heart surgery is a preventative measure to help eliminate risks of some complications following surgery, but a recent study provides new evidence suggesting that this preventative measure may be doing more harm than good.

The study, published in The Annual of Thoracic Surgery, set out to evaluate what harm dental extraction before cardiovascular surgery could have on a patient's well being. What researchers found was alarming, with a three percent increased risk of death after the dental surgery and a eight percent risk of adverse outcomes following the heart surgery.

Researchers from the Mayo Clinic in Rochester, Maine evaluated the results of 205 patients who underwent a total of 208 dental extractions before 206 planned cardiac operations. They observed the major outcomes of dental surgery up to 30 days after initial surgery and before the scheduled heart surgery. They also observed the immediate outcomes of the heart surgery.

Of those 205, eight percent (16) of the patients experienced major adverse outcomes from both surgeries. These adverse outcomes included kidney failure, stroke, and non-fatal heart attack. Twelve patients also died within the 30 days following dental extraction of which three percent occurred before the heart surgery and three percent occurred after.

Most of these major adverse outcomes and the risk of death are directly linked to individualized reactions of patients to anesthesia. The authors of the study are quick to point out that the surgical guidelines from the American College of Cardiology and the American Heart Association (AHA) claim that dental extraction, a recommended procedure before performing heart surgery, only posses a one percent risk of major complications or death.

However, the final results of this study imply something very different. The researchers claim that while dental surgery may be a preventative measure designed to help prevent infection of heart tissue following cardiovascular surgery, the adverse effects from the procedure may outweigh the benefits in the case of some patients. The study concludes that physicians should focus on evaluating the individual risks of anesthesia and additional surgical procedures before choosing whether or not to adhere to AHA guidelines.

The study was published in The Annals of Thoracic Surgery.

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