Prevalence of high blood pressure in periodontal patients: A pilot study.

BACKGROUND: Arterial hypertension and periodontal diseases are pathologies with a high prevalence worldwide. Recent evidence suggests a possible causal relationship between them. Patients with moderate or severe periodontitis tend to have higher blood pressure measurements and a 30% to 70% higher likelihood of developing hypertension. OBJECTIVES: The aim of this cross-sectional pilot study was to ascertain the prevalence of high blood pressure in patients with periodontitis. MATERIAL AND METHODS: The study included 40 patients diagnosed with periodontitis who required non-surgical periodontal treatment. Demographic, periodontal and clinical characteristics, including blood pressure measurements, were registered. RESULTS: Fifteen percent of the patients were classified as hypertensive (n = 6), 67.5% as high-normal (n = 27) and 17.5% as normotensive (n = 7). Recent studies have estimated that the prevalence of highnormal blood pressure in the general population ranges between 30% and 50%. These findings suggest that patients with periodontal disease are more likely to have elevated blood pressure than patients with healthy periodontal tissues. CONCLUSIONS: High-normal blood pressure is associated with a 3 times higher likelihood of developing hypertension, so early detection and prevention are crucial public health strategies. Despite the limitations of this pilot study, it highlights the role of dentists in the prevention, diagnosis and blood pressure control to improve health and cardiovascular risk of patients with periodontitis.

Impact of Nonsurgical Periodontal Treatment on Blood Pressure: A Prospective Cohort Study.

OBJECTIVES: Arterial hypertension and periodontitis are two of the most common diseases worldwide and recent evidence supports a causal relationship between them. Despite all antihypertensive strategies, an important number of patients are undiagnosed and a large number of the diagnosed fail to achieve optimal blood pressure (BP) measurements. Some studies point out that periodontal treatment could have positive effects on BP levels. The aim of this study is to determine if nonsurgical periodontal treatment can help BP level control in prehypertensive patients with periodontitis. MATERIALS AND METHODS: Thirty-five patients were included in the study and received nonsurgical periodontal treatment according to necessity. Clinical data, periodontal data, and BP measurements were taken at baseline, periodontal re-evaluation visit (4-6 weeks after treatment), and 6-month follow-up. RESULTS: Periodontal treatment caused a statistically significant reduction (p < 0.05) of systolic blood pressure (SBP) and diastolic blood pressure (DBP) at re-evaluation visit of 4.7 (p = 0.016) and 3.4 mm Hg (p = 0.015), respectively. The effect was maintained at 6-month follow-up visit with a reduction in SBP and DBP of 5.2 (p = 0.007) and 3.7 (p = 0.003) mm Hg, respectively. CONCLUSION: Despite the limitations of this study, it suggests that nonsurgical periodontal treatment can be effective in lowering BP levels in patients with prehypertension and periodontitis. Moreover, it highlights the importance of dentists in prevention, detection, and control of this important cardiovascular risk factor.

Does Periodontal Treatment Help in Arterial Hypertension Control? A Systematic Review of Literature.

Arterial hypertension and periodontal diseases are two of the pathologies with more prevalence worldwide. In the last few years, several scientific evidences have demonstrated the relationship between both diseases. Besides the etiopathogenic and causal relationship, some recent publications have pointed out that the therapeutic approach of periodontitis could have positive effects on the control of arterial hypertension.The aim of this systematic review is to determine whether there is a decrease in or better control of blood pressure after performing nonsurgical periodontal treatment in patients with periodontitis.A thorough search in PubMed, Scopus, and ISI Web of Science databases with the keywords "'periodontal disease' OR 'periodontitis' OR 'periodontal' AND 'blood pressure' OR 'hypertension' OR 'arterial hypertension'" was conducted. The quality of the reported information was assessed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for systematic reviews.Eight articles were considered for this systematic review. Five of the studies showed statistically significant reduction in systolic blood pressure (SBP) values.Despite the limitations of the review, nonsurgical treatment of periodontal disease seems to reduce SBP values. Further research with larger and longer-term clinical trials are needed to demonstrate this potential positive effect.

Direct oral anticoagulants and its implications in dentistry. A review of literature.

BACKGROUND: Four novel direct oral anticoagulants (DOACs) named dabigatran, rivaroxaban, edoxaban and apixaban have been recently introduced to overcome some of the drawbacks of existing anticoagulants. They have less interactions and do not require routine monitoring. However, there is not enough scientific data about the protocol to apply in these patients on DOACs undergoing dental treatment. Thus is necessary to evaluate the potential bleeding risk of these drugs, the possibility of thromboembolic events occurring if they are withdrawn or the need to change to heparin previously. MATERIAL AND METHODS: A comprehensive search of the PubMed, Scopus and ISI Web of Science databases was conducted to identify studies that evaluated the relationship between direct oral anticoagulants and dental procedures. The quality of the reported information was assessed following the PRISMA statement. RESULTS: Eleven studies that met the inclusion criteria were included in the review: 2 randomized clinical trials, 3 prospective studies, 3 retrospective studies, 2 case series and 1 case report. CONCLUSIONS: DOACs are safe drugs in terms of bleeding. The possible postoperative bleeding complications are manageable with conventional haemostasis measurements. The bridging approach with heparin does not seem to be recommended. Consensus among the professionals involved in the management of the patient is fundamental in invasive dental treatments and in complex patients. Key words:Oral anticoagulants, DOAC, NOAC, dabigatran, rivaroxaban, apixaban, edoxaban, bleeding, oral surgery.