Cardiac Surgery and Tooth Extraction a Deadly Combination


The newest danger for heart surgery patients is from no other source than dental surgery, scientists claim.  What was once thought to be a preventative measure for patients undergoing cardiac procedures, tooth extraction before heart surgery is now thought to be highly risky, and possibly a deadly combination.

Due to a recent study published in The Annals of Thoracic Surgery, prophylactic dental surgery which takes place before a patient has heart surgery can cause catastrophic complications.  The research which took place between 2003 and 2013 monitored 205 patients who had surgical tooth extraction within a week before they had a surgical procedure done to their heart.  Of the 205 participants in the study, 8% suffered from major health complications due to the surgical tooth extraction, including death, stroke, and kidney problems.  Six of the patients died after having their surgical tooth extraction, before even going under the knife for a cardiac procedure.  Another six patients who did have heart surgery died in the hospital shortly after the procedure.  Fourteen of the patients ended up needing to delay the date for heart surgery due to complications with the surgical tooth extraction that would have made heart surgery highly risky.  In addition, ten of the patients who had heart and dental surgery within one week had major negative outcomes after, including acute coronary syndrome, stroke,  and kidney failure.  Of these patients who suffered from surgical complications, dialysis and postoperative mechanical ventilation was needed for some.

Of the 205 patients who took part in this study 80% were males and the average age of participants was 62.  The patients were needing heart surgery for several reasons including heart disease complications, valve replacements, and heart transplants, among other procedures.  The study, which was funded by the Mayo Clinic now has physicians re-thinking dental extraction before cardiac surgery.

Originally doctors had recommended surgical tooth extraction to patients with infected or abscessed teeth before having open heart surgery as a preventative measure.  The dental surgery was thought to reduce risk of the patient experiencing medical complications due to dental infections, as the bacteria in the infected teeth and gums can travel through the bloodstream and cause infections in the heart.  One such complication is infective endocarditis, an infection of the inner lining of the heart.  If a patient contracts this infection the outcome can be fatal. As research denotes, 38% of patients who contract endocarditis end up dying.  However, with the results of this recent research on the effect of tooth extraction before cardiac surgery, doctors are finding that having the two procedures can be a deadly combination.

There are several hypothesized reasons for the deaths of the patients who underwent dental and heart surgery within one week, however physicians haven’t found a definitive cause for complications.  Patients who experienced negative health outcomes after subsequent dental and heart surgeries may have suffered due to the amount of stress placed on the heart by the procedures, doctors surmise.  Also, doctors have also linked elevated blood pressure rates due to dental surgery with negative heart surgery outcomes.

This study has stirred much debate over whether patients needing cardiac surgery should have infected teeth removed first.  While the results of tooth extraction before cardiac surgery have proven to be a deadly combination for some, doctors are calling for more research with more definitive answers before nixing tooth extraction as a preventative procedure.

By Allison Longstreet



Infection Control Today