title: Dental procedures and risk of experiencing a second vascular event in a Medicare population.
abstract: BACKGROUND
  Practice guidelines historically have recommended postponing dental care after ischemic vascular events. The authors examined an administrative data set to determine whether dental procedures increased patients' risk of experiencing a second vascular event.
  
  
  METHODS
  The authors examined a data set of 50,329 participants in the Medicare Current Beneficiary Survey to identify those who had had a vascular event (n = 2,035) and a second event (n = 445) while in the survey. They used Cox proportional hazards regression to study associations between dental procedures performed within 30, 60, 90 or 180 days after a first event and the risk of experiencing a second vascular event.
  
  
  RESULTS
  Dental procedures of any kind, and invasive procedures considered separately, were not associated with patients' risk of experiencing second vascular events across all periods examined. Most hazard ratios associated with dental procedures were less than 1.0, although none differed significantly from 1.0.
  
  
  CONCLUSIONS
  The authors found that community-dwelling Medicare beneficiaries who underwent dental procedures within 30 to 180 days after an ischemic vascular event, including those that produce a bacteremia consistently, were not at an increased risk of experiencing a second event.
  
  
  CONCLUSIONS
  The results of this study suggest that clinicians should reassess historical recommendations that dental care in this population be postponed for as long as six months after an ischemic vascular event.
authors.affiliation: School of Dentistry, University of Minnesota, 7-368 Moos Tower, 515 Delaware St. S.E., Minneapolis, Minn. 55455, USA. skaar003@umn.edu
authors.forename: Daniel
authors.initials: D
authors.lastname: Skaar
authors.forename: Heidi
authors.initials: H
authors.lastname: O'Connor
authors.forename: Scott
authors.initials: S
authors.lastname: Lunos
authors.forename: Russell
authors.initials: R
authors.lastname: Luepker
authors.forename: Bryan S
authors.initials: BS
authors.lastname: Michalowicz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology; D002545:Brain Ischemia / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology; D003729:Dental Care / Q000706:statistics & numerical data*; D003777:Dental Prophylaxis / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data*; D017202:Myocardial Ischemia / Q000453:epidemiology*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D016016:Proportional Hazards Models; D012008:Recurrence; D012307:Risk Factors; D012390:Root Canal Therapy / Q000706:statistics & numerical data; D057566:Self Report; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology*; D014081:Tooth Extraction / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
chemical_list: D010975:Platelet Aggregation Inhibitors