According to the World Health Organization, hypertension affects about 30% of the global adult population and is a contributing factor to premature death and disability.
Hypertension is a chronic medical condition characterized by high blood pressure which is associated with heart disease. Studies link periodontal disease to hypertension, making the health screening of dental patients crucial.
Hypertension facts
- Hypertension, diabetes and cigarette smoking are considered to be traditional risk factors for heart disease
- At the same time, hypertension, diabetes, and heart disease have been associated with periodontal disease
- Hypertension is defined when a patient has an elevated systolic blood pressure greater than 140 mmHg and/or diastolic blood pressure greater than 90 mmHg
- Prehypertension is defined when a patient has systolic blood pressure ranging between 120 mmHg and 139 mmHg, and/or diastolic blood pressure of 80 mmHg to 89 mmHg
Systemic impact
- Hypertension causes changes in microcirculation, leading to ischemia in the periodontal tissues, which creates favorable conditions for periodontal disease to spread
- Periodontal disease and hypertension share multiple common risk factors which should be recognized by health professionals and minimized through treatment
- Patients with poor oral health and heightened C-reactive protein (CRP) require a medical evaluation with blood pressure measurement alongside a comprehensive periodontal examination
What can dental professionals do?
There is mounting evidence (through animal and population-based studies) that point to periodontal diseases being linked with systemic diseases which needs to be better understood by dental and medical professionals in order to advance patient care.
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- Bleeding on probing is an earlier and sensitive indicator of inflammation and deepened periodontal pocket depth
- A maintained healthy weight and regular exercise are important factors to help keep a normal blood pressure and prevent hypertension and future diseases
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- The level of serum high-sensitivity CRP (hs-CRP), an acute-phase reactant that has been reported to predict the outcome of heart disease, was found to be more prevalent in patients with periodontitis than in control subjects, and it decreased significantly after periodontal treatment
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- It should be explained to patients with prehypertension that their periodontal disease should be treated with urgency in order to avoid a further impact on systemic health
- Weight loss is a valuable treatment goal in hypertensive patients. Therefore healthy eating and exercise regimes should be encouraged with a view to improving hypertension
"Oral health care providers can become advocates for healthy living, including diet management and limiting sugar intake. These new responsibilities fit well with our understanding of the etiology of dental disease."
Professor Ira Lamster, Editor of the International Dental Journal