Anxiety Over Tooth Extraction May Stress Heart


Fri Apr 26, 2002 5:40 PM ET

NEW YORK (Reuters Health) – Going to the dentist for a tooth extraction is stressful for just about everyone. But the findings of a new study suggest that patients with severe heart disease should get extra-special care because the stress of the ordeal could bring on heart problems.

Writing in the April issue of the Journal of the American Dental Association, two Italian researchers report that patients with severe heart disease and “those who have reduced cardiac performance have some trouble facing stressful situations such as dental extractions.”

In their investigation, Drs. Lucio Montebugnoli and Carlo Prati of the University of Bologna measured blood pressure and heart rate before, during, and after a tooth extraction in four different groups of people classified as either having mild heart disease, severe heart disease, a heart transplant, or completely healthy.

Those with severe heart disease had more trouble bringing their heart rate and blood pressure back to normal after experiencing the stress of a dental procedure, the investigators found.

“The data from this study agree with those of a recent report suggesting that the management of patients who have heart disease can differ depending on the cardiac status of the patient,” Montebugnoli and Prati write.

Specifically, the authors report that patients with mild heart disease appeared to do as well as healthy people with regard to blood pressure before, during, and after their tooth extraction. Patients that had previously undergone heart transplant surgery also seemed to fair well during a tooth extraction, they note.

“Mild heart disease patients can tolerate even highly stressful situations since their circulatory dynamics adapt well to ongoing situations, while severe heart disease patients who fail to adapt well to ongoing circumstances are at high risk of experiencing heart failure at any time during all dental procedures,” the researchers conclude.

“The decision to proceed with dental treatment should be based on a comprehensive assessment of the cardiovascular condition of each patient,” they suggest.

SOURCE: Journal of the American Dental Association 2002;133:468-472.

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