High blood pressure in periodontal disease – an updated science

Patients with periodontal disease are more likely to have high blood pressure. British researchers reported in the Journal of “High Blood Pressure” that early diagnosis and successful treatment of a bacterial tooth infection can suppress the general inflammation in the body and thus restore the work of damaged blood vessels to normal. While tooth decay attacks only the material of the tooth, periodontitis causes inflammation of the so-called periodontal structure. Some oral bacteria initially multiply in gum pockets and then destroy both tooth and bone tissue, which, if left untreated, leads to tooth loss. Pathogens can also spread through the bloodstream and cause infections in other parts of the body.

“We often notice high blood pressure in periodontal patients, especially if they have active gingivitis or bleeding gums,” says Eva Muñoz Aguilera of University College London. “Gum disease pathogens damage the gums and lead to inflammatory processes, which can promote the development of systemic diseases such as high blood pressure,” explains the head of the department, Francesco Dioto. High blood pressure occurs in about a third of the population, but it often passes unnoticed and untreated. Significantly high blood pressure increases the risk of developing cardiovascular disease, including stroke and heart attack.

The researchers looked at two groups of 250 adults, each with an average age of 35 years. Members of one group suffered from severe periodontal disease but were in good health. In the other group, this dental disease was not diagnosed. The number of white blood cells and the content of C-reactive protein (CRP) in the blood samples provided information about the extent of inflammatory processes in the body. For statistical comparison, the age, gender, body mass index (BMI), tobacco consumption, and physical activity of the individual test subjects were taken into account.

The mean systolic blood pressure in periodontitis patients was 3.4 mm Hg, which is over 140 in 14 percent of cases. In the control group, only 7 percent achieved these high values. Bleeding gums – the first sign of periodontitis – was actually associated with elevated blood pressure values. Periodontal disease patients have higher white blood cell counts and CRP. Although this was not directly proven in this study, some studies that have led to hypotension indicate a causal relationship, the authors write.

“Our results also confirm that a worrying number of people are not aware of their potential high blood pressure values,” says D’Aiuto. Dentists who diagnose periodontal disease should advise these patients to have their blood pressure checked. If necessary, dental disease and high blood pressure can be treated at the same time. Regular tooth brushing and preventive examinations help prevent the development of periodontitis and thus reduce the risk of high blood pressure.