Invasive Dental Treatment and Risk for Vascular Events

Joseph D. Matthews

doi:10.7326/0003-4819-154-6-201103150-00015

Letters |15 March 2011

Invasive Dental Treatment and Risk for Vascular Events

Joseph D. Matthews, DDS, MSc

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Potential Conflicts of Interest: None disclosed.

TO THE EDITOR:

Minassian and colleagues' study (1) highlighted the difficulty of applying results from retrospective studies of claims data to clinical practice. The most important confounder that was not discussed by the authors is the proximity of tooth extraction to an odontogenic infection or other acute condition that would necessitate invasive dental treatment.

Because the analysis was restricted to dental extractions, ascertaining the reason for the extraction in each case would have been important. Extraction is rarely elective and, in fact, is often delayed until an acute condition makes successful alternatives unlikely. One recent study (2) found that dental caries and its sequelae or periodontal disease caused more than 80% of tooth extractions. It seems far more likely that patients in Minassian and colleagues' study who had vascular events were experiencing sequelae from the disease itself rather than from treatment of the disease.

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Letters |15 March 2011

Invasive Dental Treatment and Risk for Vascular Events

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Letters |15 March 2011

Invasive Dental Treatment and Risk for Vascular Events

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