Does Toothache Before a Dental Visit Associate with the Risk of a First Myocardial Infarction?

Background/Objectives: Ischemic heart disease is typically characterized by chest pain that sometimes radiate to other areas, including the orofacial region. Atypical clinical presentation of cardiac disease risks leading to a delay in the diagnosis and treatment. Symptoms in the orofacial region may also lead to unnecessary dental interventions. The objective of this study was to assess occurrence of toothache, or other oral problems, that prompted a visit to a dental office prior to a first myocardial infarction. Methods: In 2010 until 2014, a total of 805 patients hospitalized for a first myocardial infarction and 805 controls matched for age, sex, and postal code area, were recruited to the case-control study PAROKRANK (Periodontitis and its relation to cardiovascular disease). In addition to medical and oral examinations that included panoramic radiography and blood sampling, all participants responded to a survey that covered questions related to oral habits and dental service use. The present study focused on responses to questions concerning the most recent visit to a dental office, specifically if toothache, chewing problem, and/or other problems with the teeth were present, whilst also taking endodontic variables into consideration. Results: Time since the most recent visit to a dental office ranged between 0-14 years, with a mean value of 1.08 years and no difference between patients and controls. A majority of responders (80.9%) gave the reason to be a routine dental examination. Toothache as the reason was reported by 146 (11.5%) respondents: 71 (10.9%) patients and 75 (12.1%) controls (p = 0.59). No difference was observed between patients and controls. Conclusions: Within the limitations of the present study design, seeking dental care for toothache was not associated with the risk of a subsequent first myocardial infarction.