Blood Pressure and Tooth Loss: A Large Cross-Sectional Study with Age Mediation Analysis

Abstract

We aimed to investigate the association between blood pressure (BP) and tooth loss and the mediation effect of age. A cross-sectional study from a reference dental hospital was conducted from September 2017 to July 2020. Single measures of BP were taken via an automated sphygmomanometer device. Tooth loss was assessed through oral examination and confirmed radiographically. Severe tooth loss was defined as 10 or more teeth lost. Additional study covariates were collected via sociodemographic and medical questionnaires. A total of 10,576 patients were included. Hypertension was more prevalent in severe tooth loss patients than nonsevere tooth lost (56.1% vs. 39.3%, p < 0.001). The frequency of likely undiagnosed hypertension was 43.4%. The adjusted logistic model for sex, smoking habits and body mass index confirmed the association between continuous measures of high BP and continuous measures of tooth loss (odds ratio (OR) = 1.05, 95% CI: 1.03–1.06, p < 0.001). Age mediated 80.0% and 87.5% of the association between periodontitis with both systolic BP (p < 0.001) and diastolic BP (p < 0.001), respectively. Therefore, hypertension and tooth loss are associated, with a consistent mediation effect of age. Frequency of undiagnosed hypertension was elevated. Age, gender, active smoking, and BMI were independently associated with raised BP.

Tooth Loss and Blood Pressure in Parkinson’s Disease Patients: An Exploratory Study on NHANES Data

“…When it comes to the association of missing teeth with systemic health parameters in PD patients, a positive association was found with BP levels, as previously reported [ 34 , 56 , 57 ]. However, there was no significant data supporting an association between Hba1c and the number of missing teeth, contradicting literature on the edentulism–DM link abovementioned [ 55 ].…”

“…Firstly, the study sample was acquired from a large representative U.S. population survey, from a vast collection of datasets through an 18-year time span (2001–2018). Additionally, our research aimed to evaluate a previously proven association between BP and tooth count [ 34 ], but this time in a group of patients taking PD-based medication. Notwithstanding and despite the reproducibility of the study design, the final included sample was relatively small.…”

“…Thus, the following dentition-related variables were computed: total number of teeth present, total number of missing teeth, number of implants, number of molars, premolars and canines. Tooth loss was categorized as “severe” if 10 or more teeth were lost, and “non-severe” if less than 10 teeth were lost [ 34 ].…”

The Relationship Between Tooth Loss and Hypertension: a Systematic Review and Meta-analysis

“…In terms of the number of teeth, 10 studies evaluated the number of missing teeth [32][33][34][35][36][37][38][39][40]51 and 10 studies evaluated the number of remaining teeth [41][42][43][44][45][46][47][48][49][50] . In the analyses, only four studies used measured values [34][35][36]40 while the other 16 categorized measured values.…”

“…For all the studies, there was a clear focus. Five of the studies (cross sectional) recruited subjects from a clinical setting 32,35,38,42,43 , which has a higher risk of selection bias. Seven studies used self-reported information on the number of teeth and four studies used self-reported information for hypertension in their analyses, which lowed the rating.…”