Atrial fibrillation and cardiac arrhythmia associated with acute dental infection: a systematic literature review and case report

OBJECTIVES: This paper outlines how oral diseases such as periodontitis and periapical periodontitis may be linked to cardiovascular disease, atrial fibrillation and cardiac arrhythmia. We undertake a systematic review of the literature focused on acute dental infection and types of cardiac arrhythmia and also describe an illustrative case where an acute dental infection diagnosed as periapical periodontitis was associated with the occurrence of atrial fibrillation.

METHODS: An electronic search was undertaken using MEDLINE and SCOPUS from 01 Jan 1970 to 30 June 2020. We also undertook manual searches using forward and backward citation chasing. Inclusion criteria were any primary research studies investigating any acute dental infection, with outcomes of cardiac arrhythmia or atrial fibrillation.

RESULTS: Over the last fifty years, only two low-quality studies have been investigated in this area. Our illustrative case involved a 58 year-old who was diagnosed with an acute dental infection from an upper canine tooth who then developed atrial fibrillation.

CONCLUSIONS: Based on the biological plausibility of a link between acute dental infection and types of cardiac arrhythmia such as atrial fibrillation, together with the case report presented, it is evident that further study in this area is needed. If there are possible cardiovascular consequences for patients suffering from acute dental infection, then this will have implications for healthcare staff since they can integrate professional advice relating to oral health with cardiovascular disease and atrial fibrillation. Screening programmes situated in dental settings can facilitate early intervention and prevention producing benefits for patients and savings to the health system.