He who takes care of the mouth also takes care of the heart. In fact, the treatment of periodontitis reduces high blood pressure by 11 points and is more effective than a low-salt diet. This is indicated by a report published by the Italian Society of Periodontology and Implantology (SIdP), and by the Italian Society of Arterial Hypertension (Siia), presented at the SIdP national congress. Periodontitis – the experts explain – is associated with a higher risk of high blood pressure, a correlation that has been proven for some time by a growing number of studies and still little known to doctors and patients. Therefore, periodontal treatment improves the control of hypertension more effectively than a low-salt diet which is still essential in addition to pharmacological therapy.
“Hypertension affects 30 to 45% of the adult population, over 20 million people in Italy, and is among the main causes of death from heart attacks and strokes“, remember Nicola Marco Sforza, SIdP president. “Likewise, periodontitis affects over 50% of individuals, more than 30 million in our country, and is associated with a higher risk of suffering from high blood pressure which, in cases of severe periodontitis, can even double. This interconnection between the two diseases, demonstrated by an increasing number of studies, adds new scientific evidence according to which the treatment of periodontitis helps to lower blood pressure levels by as much as 11 points, if gum bleeding is reduced by 30% with a deep cleaning of the gingival pockets and correct oral, professional and home hygiene”.
“The study reported by the SIdP and Siia joint report considered 100 hypertensive patients with gum disease: 50 underwent supra- and subgingival hygiene, i.e. deep pocket cleaning and professional oral hygiene, and the other 50 in the control group underwent only a simple surface cleaning,” he reports Davide Pietropaoli, author of the study, coordinator of the SIdP SIIA practical guide and researcher at the University of L’Aquila. “After two months, in the supra- and sub-gingival hygiene test group, the periodontal treatment – he explains – resulted in a benefit of 11 points less in blood pressure, with an efficacy greater than double the low-salt diet”.
“This evidence – he adds Luca Landi, past president SIdP – indicates that periodontitis makes the endothelial tissue lining the arteries less elastic and therefore less able to adapt when the heart pumps, with a consequent increase in blood pressure. Because of this adding gingival disease treatment to the pharmacological strategy and antihypertensive diet makes therapy more effective and improves the management and control of high blood pressure”.
Hypertension and periodontitis share many risk factors: smoking, obesity, diabetes and a sedentary lifestyle. Furthermore, recent experimental evidence indicates that periodontitis and hypertension have a common genetic basis, particularly in a large group of genes important for the immune system, supporting the fact that behind both pathologies there is a chronic inflammatory condition. For this SIdP and Siia have joined forces and developed a practical guide on correct diagnostic and treatment pathways and an informative handbook with practical recommendations for cross-diagnosis and screening. “With a few simple questions about blood pressure, the dentist will be able to identify patients with gum inflammation with a higher risk of hypertension for whom blood pressure control is needed, inviting them to consult a specialist,” observes Sforza.
“On the other hand, it is also of fundamental importance for the internist or cardiologist to include in the patient’s assessment some questions on the state of oral health that can represent a warning light for a potential risk of periodontitis”, he adds Guido Grassi, past president of SIIA and president of the European Society of Hypertension (Esh). “This simple evaluation can be very useful both in identifying people with a higher risk of hypertension and in the early diagnosis of this disease in those who do not know they have it”. “This is why the projects that SIdP is carrying out in collaboration with other scientific societies in the medical area they promote a holistic approach to the patient and aim to make the dental practice a global health hub”, concludes Marco Sforza.