Unfinished Root Canal Treatments and the Risk of Cardiovascular Disease

Introduction: Root canal treatments (RCTs) aim to eradicate pulpal diseases and save the infected teeth by eliminating microorganisms from the root canal system. Starting but not finishing an RCT can perpetuate a dead space for bacterial growth, which can spread to other sites in the body and develop systemic symptoms. The objective of the present study was to investigate the association between unfinished RCTs and the risk of cardiovascular disease (CVD) using a nationwide population-based database. Methods: A total of 283,590 participants who received at least 1 RCT and with no cardiovascular history before 2005 were recruited and followed until the end of 2011. An unfinished RCT was defined as a tooth on which an RCT was started but with no completion code. Cox proportional hazards models were used to estimate the effect of unfinished RCTs on the risk of CVD. Results: A total of 3626 participants underwent CVD hospitalization during an average observation period of 6.01 years, thus yielding an overall CVD hospitalization incidence rate of 0.21% per person year. Compared with the participants with no unfinished RCTs, the adjusted CVD hospitalization hazard ratio for the participants with 1 or 2 unfinished RCTs was 1.22 (95% confidence interval, 1.11-1.35) and for those with 3 or more unfinished RCTs, it was 3.61 (95% confidence interval, 2.36-5.51; test for trend, P < .0001). Conclusions: Participants with unfinished RCTs were associated with a higher risk of CVD hospitalization.