Association between high blood pressure and deep periodontal pockets: a nested case-referent study

A hypertension screening project was performed jointly at a dental clinic and a primary health care centre. In this report the hypothesis that there is an association between high diastolic blood pressure and deep periodontal pockets was tested. A total of 1,239 consecutive patients aged 35-65 years had their blood pressure measured before the dental examination or had a known hypertension. Information on medical history and tobacco use was obtained by interview and dental status was recorded. Fifty-four subjects had known hypertension and 141 had previously unknown diastolic blood pressure >90 mmHg (cases). For each case an age, sex and tobacco-use matched referent was chosen from those with diastolic blood pressure < or =90 mmHg. Significantly more cases than referents had periodontal pockets > or = 5 millimeters deep. In multivariate analyses the prevalence of deep periodontal pockets was associated with blood pressure status also after adjustment for the small differences between the groups in age, sex, tobacco use and number of teeth. In conclusion there was an association between diastolic blood pressure and prevalent deep periodontal pockets. Whether the relationship is a causal one remains to be explored. Screening for high blood pressure at regularly visits at the dental clinic may give the dental care a new important role in the public health field.