Bad Gums and High Blood Pressure

It is funny how the body works. When we talk about the causes of hypertension, the largest single killer in the world, we generally list a bunch of causes starting from genetics to stress to obesity to lack of physical activity, but we do not associate high blood pressure with bad teeth or gums.

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There is now mounting evidence [1,2] that periodontal disease is a key driver of hypertension. While the exact pathophysiology is still debated, it is believed that long standing periodontal disease leads to chronic inflammation in the body, which can also change the gut microbiome and together cause oxidative stress and produce hypertension (Fig. 1).

The study by Eva Munoz Aguilera and her colleagues [1] found that those with periodontitis were twice as likely to have systolic hypertension and a 50% greater likelihood of diastolic hypertension.

In case you are wondering what bad gums look like, take a look at this picture.

Fig. 2: Periodontitis - mild to moderate. Courtesy Geaninamiu.

In India, it is estimated that around 50% of the adult population [3] has some form of periodontal disease. Given that 30-60% of the adult Indian population has hypertension depending on the criteria used, both are really high numbers. While currently, we do not know how many of the people with hypertension in India have periodontal disease and vice versa and how many people would have improved blood pressure levels, just by getting their periodontitis treated, the theory is that taking care of gum disease and bad teeth could lead to an overall improvement in general health parameters including high blood pressure.

What is your matka here? If you are one of the 50% adult Indians with bad gums, go to your dentist and get it treated…like physical activity, this is a low cost, non-drug intervention that may help. Also check your blood pressure regularly to ensure that you are not a silent hypertensive. You can do this yourself at home.

Who would have thought! Healthy teeth and gums can mean a lower risk of high blood pressure.

Footnotes

1. Muñoz Aguilera E, Suvan J, Orlandi M, Miró Catalina Q, Nart J, D'Aiuto F. Association Between Periodontitis and Blood Pressure Highlighted in Systemically Healthy Individuals: Results From a Nested Case-Control Study. Hypertension. 2021 May 5;77(5):1765-1774. doi: 10.1161/HYPERTENSIONAHA.120.16790. Epub 2021 Mar 29. PMID: 33775115.

2. Guzik TJ, Czesnikiewicz-Guzik M. Mounting Pressure of Periodontitis. Hypertension. 2021 Jun 21:HYPERTENSIONAHA12117450. doi: 10.1161/HYPERTENSIONAHA.121.17450. Epub ahead of print. PMID: 34148358.

3. Janakiram C, Mehta A, Venkitachalam R. Prevalence of periodontal disease among adults in India: A systematic review and meta-analysis. J Oral Biol Craniofac Res. 2020 Oct-Dec;10(4):800-806. doi: 10.1016/j.jobcr.2020.10.016. Epub 2020 Oct 27. PMID: 33204609; PMCID: PMC7649635.