Hypertension is Associated with Tooth Loss and Inflammation

Objectives: This retrospective cross-sectional study aimed to correlate hypertension with demographic, behavioral and periodontal clinical parameters.
Methods: A convenience sample population of 607 individuals (30-77 years of age; 62% females) who sought oral care in a Public Dental School was selected. All individuals filled in oral and general health questionnaires, and had full mouth periodontal clinical examination. Hypertension and antihypertensive medication information was self-reported. Associations between hypertension and all other parameters were analyzed by Chi-square and Mann-Whitney tests.
Results: 89/607 (14.7%) patients reported to have hypertension, and 66.3% were under medication. No association between hypertension and smoking was observed, although there was a significantly higher proportion of hypertensive females than males (p=0.039). Hypertensive patients presented more gingivitis compared to non-hypertensive individuals (p<0.05). Patients with hypertension were significantly older and presented higher mean number of missing teeth (49.9±10 and 7.1±5.7, respectively) than controls (43.5±9 and 4.7±4.5, respectively, p<0.05).IN contrast, hypertensive patients presented significantly less mean probing depth and attachment loss (AL), as well as less % of sites with suppuration, moderate to deep pockets and/or AL (p<0.05) compared to non-hypertensive individuals, regardless of the periodontal status. Within hypertensive patients, those under medication presented significantly less moderate to deep pockets, gingival bleeding and supragingival biofilm (p<0.05) than those without any antihypertensive medication.
Conclusions: Within the limitations of this study, self-reported hypertensive individuals from this sample population were older and presented higher number of missing teeth; however, no positive association between hypertension and periodontal attachment loss was observed. Moreover, medicated hypertensive individuals presented less inflammation, biofilm accumulation and periodontal pockets compared to non-medicated individuals.