Tooth extraction is a common dental procedure to remove one or more teeth. It is often done when a tooth is damaged, decayed, or infected beyond repair. Some of the most common reasons for tooth extraction include severe tooth decay/injury, advanced periodontal disease, crowding, wisdom teeth extraction, and orthodontic treatment.
While tooth extraction is a routine procedure, some patients may experience common side effects like pain, swelling, and bleeding afterwards. There has also been some concern that tooth extraction could potentially lead to an increase in blood pressure.
In this article, we will look at the evidence surrounding the relationship between tooth extraction and blood pressure changes. Can removing a tooth or teeth truly cause your blood pressure to spike? Read on as we dive into the research and uncover whether this dental procedure can impact your cardiovascular health.
What Happens During Tooth Extraction?
Before looking at the effects, it is important to understand what happens during a tooth extraction procedure. Here are the basic steps:
- Numbing medication is administered to block pain in the area of the tooth.
- Once the area is numb, the dentist will detach the tooth and surrounding gum tissue from the bone.
- The tooth is then grasped with dental instruments and gently rocked back and forth to loosen it from its socket.
- Finally, the dentist extracts the tooth fully from its socket.
- Pressure is applied to the site to stop bleeding and the area is stitched closed.
This entire process usually takes less than an hour. Most simple extractions can be performed quickly and comfortably with just local anesthetic. More complex cases may require an incision and removal of bone.
During the procedure, patients can experience physical stress from dental instruments entering the mouth, loss of blood, and pressure or pulling sensations when the tooth is removed. The body reacts to this stress through hormonal and other mechanisms.
This is why tooth extraction can sometimes produce temporary cardiovascular effects like increased heart rate and blood pressure. But do these temporary spikes necessarily lead to sustained high blood pressure after the procedure?
Short-Term Pressure Changes During Extraction
Research shows that blood pressure typically rises during the process of having a tooth extracted.
One study monitored blood pressure in 104 patients before, during, and after tooth extraction. It found that:
- Systolic blood pressure increased an average of 14.9 mm Hg
- Diastolic blood pressure increased an average of 7.8 mm Hg
The increases occurred as the tooth was being extracted and immediately afterwards. They also found larger blood pressure increases in anxious patients.[1]
Another study examined cardiovascular parameters in 80 healthy patients undergoing simple tooth extraction. It similarly found significant increases in:
- Systolic and diastolic blood pressure
- Heart rate
- Rate pressure product (heart rate x systolic blood pressure)
On average, systolic blood pressure increased by 23 mm Hg and diastolic by 17 mm Hg during extraction. Heart rate went up by 16 beats per minute. All measurements peaked when the tooth was actually being removed.[2]
Other studies have reported average blood pressure increases of around 20/15 mm Hg during extraction procedures.[3][4]
In essence, these temporary spikes are due to your body’s normal response to physical stress, pain, anxiety, and blood loss. Your sympathetic nervous system activates, releasing stress hormones like adrenaline and cortisol. This leads to accelerated heart rate, constricted blood vessels, and surging blood pressure while the tooth is coming out.
Do Pressure Changes Persist After Extraction?
While extraction clearly increases blood pressure temporarily, the key question is whether it causes high blood pressure that persists afterwards.
Several studies have looked at this by monitoring blood pressure in the hours and days following tooth extractions:
- One study found that blood pressure declined to normal within 10 minutes after extraction and remained stable in the hour afterwards.[1]
- Another reported that both systolic and diastolic pressure normalized within 30 minutes post-procedure.[2]
- Research measuring blood pressure on subsequent days found no lasting impact from simple extractions.[5]
Based on these findings, isolated tooth extraction does not appear to cause sustained spikes in blood pressure. The increases are temporary reactions to the procedure itself.
However, it is important to note that certain patients may be more vulnerable to longer-lasting effects. Those with preexisting hypertension or anxiety disorders seem to be more likely to experience elevated blood pressure that persists for hours to days afterwards.[5]
But even in these higher risk cases, the effect seems modest. One study found just a 6 mm Hg average increase in systolic blood pressure at 24 hours post-extraction in hypertensive patients.[6]
So in most cases, blood pressure returns to normal within half an hour after tooth removal. Even when transient hypertension occurs, it rarely lasts beyond the first day following extraction.
Impact of Multiple Extractions
What if you need more than one tooth pulled at a time? Can extracting multiple teeth lead to greater cardiovascular impact?
Research suggests the number of teeth removed does not make a major difference in blood pressure response.
For example, one study compared single vs. multiple extractions in otherwise healthy patients. The average increases were near identical:[7]
| Extraction Type | Systolic BP Increase | Diastolic BP Increase |
|---|---|---|
| Single Tooth | 22 mm Hg | 13 mm Hg |
| Multiple Teeth | 21 mm Hg | 14 mm Hg |
Another study also concluded there was no difference in acute pressure response between single and multiple extractions.[8]
Therefore, whether you have one tooth extracted or several teeth pulled at once, the immediate blood pressure spikes are generally similar in magnitude. The cardiovascular system reacts to the overall surgical stress, not necessarily the number of extractions.
That said, having a greater amount of surgery and healing can sometimes prolong effects like pain, swelling, and recovery time. So in theory, multiple teeth removed could mean it takes slightly longer for your blood pressure to stabilize afterwards. But the effect is minor and temporary.
Impact of Tooth Extraction on Long-Term Blood Pressure
Up to this point, we have focused on the immediate and short-term blood pressure changes around the time of having a tooth extracted. But could tooth loss impact cardiovascular health months or years down the line?
Some research has associated tooth loss with greater risk of high blood pressure later in life. For example:
- One study found that people missing 9 or more teeth had a 14% higher risk of developing hypertension over 20 years.[9]
- Data from over 57,000 patients found those with fewer than 10 teeth remaining were 23% more likely to have high blood pressure.[10]
However, it is unlikely that the extractions themselves directly caused sustained increases in blood pressure. More plausibly, severe tooth loss is a marker for chronic infection, inflammation, and conditions like periodontal disease. It is these indirect factors that may contribute to cardiovascular disease over time.
For instance, research shows that chronic oral bacteria and inflammation due to gum disease can spread throughout the body, potentially damaging blood vessels and raising long-term cardiovascular risks.[11] Treating these underlying conditions may lower likelihood of hypertension later on.
So tooth loss does seem to correlate with higher cardiovascular risk, but through indirect mechanisms that develop years later. The tooth extractions themselves appear to only cause short-lived blood pressure spikes that resolve soon afterwards.
Precautions to Minimize Pressure Increases
While tooth extraction is not likely to directly cause lasting hypertension, patients and dentists can take some simple precautions to minimize temporary blood pressure increases during and after the procedure:
- Use local anesthetic – This numbs the area to blunt pain and reflex spikes during the surgery.
- Consider sedatives or anti-anxiety medication – For highly anxious patients, these can dampen the stress response.
- Monitor vitals – Check blood pressure before, during, and after extraction to ensure no concerning spikes or drops occur.
- Adjust medications – Patients taking medication for high blood pressure or other conditions may need dosage adjustments around the time of surgery.
- Avoid exertion immediately after – Take it easy for the rest of the day to prevent adding physical stress.
- Follow post-op instructions – Take prescribed medication, use ice packs, maintain gauze pressure, and limit activity to aid healing.
Following extraction, contact your dentist promptly if you experience symptoms like severe headaches, chest pain, shortness of breath, or blood pressure above 180/120 mm Hg. With proper monitoring and precautions, complications are rare.
Conclusion
In conclusion, having a tooth extracted is likely to cause a temporary spike in your blood pressure from the stress of the procedure. However, current research indicates tooth extraction does not directly lead to lasting high blood pressure or hypertension.
Pressure increases are short-lived, returning to normal within hours after extraction. Proper numbing and monitoring can minimize cardiovascular effects. While severe tooth loss correlates with long-term cardiovascular risks, this is likely due to inflammatory factors rather than extraction itself.
In most cases, patients without preexisting blood pressure problems can undergo tooth extraction without concern for lasting impact. But be sure to follow your dentist’s post-operative instructions to facilitate swift healing. With proper care after the procedure, your blood pressure should be back to baseline within a day.
