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CHICAGO-To reduce stress and possibly the risk of a heart attack, people with a history of heart disease should schedule short, early in the day dental appointments, according to a new study in the April Journal of the American Dental Association. In addition, dentists should use stress- and anxiety-reduction techniques and complete pain control methods with these patients.

Researchers from the Department of Oral Science, University of Bologna, Italy, divided 80 patients into four groups: those with minimal heart disease, severe heart disease, heart transplants and a control group (normal heart function) and monitored their blood pressure at rest, after anesthesia was given and during a tooth extraction.

Patients with minimal heart disease fared the same as the control group-their cardiac performance was good enough to permit them to undergo even highly stressful situations, such as tooth extraction, without circulatory impairment. Transplant patients also dealt well with the stress, though the researchers cautioned that these patients require individualized assessment for cardiovascular and other health risks.

However, results of the study indicate patients with severe heart disease whose blood pressure fails to adapt well to stress are at high risk of experiencing heart failure during dental procedures.

"Even minimal increases in heart rate and blood pressure could result in undesirable and potentially complicated demands on [these patients'] hearts," says the study's lead researcher, Lucio Montebugnoli, M.D., D.D.S.

Dr. Montebugnoli cautions patients to have comprehensive cardiovascular assessments and to make their dentists aware of those findings.

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Note: Although the article referenced above appears in The Journal of the American Dental Association (JADA), it does not necessarily reflect the policies or opinions of the American Dental Association (ADA).