Pathological periodontal pockets are associated with raised diastolic blood pressure in obese adolescents

Abstract

BackgroundObesity, a well-known risk factor for developing cardiovascular disease (CVD), is associated with chronic periodontitis in adults. This cross-sectional pilot study on obese adolescents was designed to investigate whether periodontal disease in terms of pathological periodontal pockets is associated with raised blood pressure and other risk markers for CVD.MethodsThe study included 75 obese subjects between 12 to 18 years of age, mean 14.5. Subjects answered a questionnaire regarding health, oral hygiene habits and sociodemographic factors. A clinical examination included Visible Plaque Index (VPI %), Gingival inflammation (BOP %) and the occurrence of pathological pockets exceeding 4 mm (PD ≥ 4 mm). Blood serum were collected and analyzed. The systolic and diastolic blood pressures were registered.ResultsAdolescents with pathological periodontal pockets (PD ≥ 4 mm; n = 14) had significantly higher BOP >25% (P = 0.002), higher diastolic blood pressure (P = 0.008), higher levels of Interleukin (IL)-6 (P < 0.001), Leptin (P = 0.018), Macrophage Chemoattractant Protein-1 (MCP-1) (P = 0.049) and thyroid stimulating hormone (TSH) (P = 0.004) in blood serum compared with subjects without pathological periodontal pockets (PD ≥ 4 mm; n = 61). The bivariate linear regression analysis demonstrated that PD ≥ 4 mm (P = 0.008) and systolic blood pressure (P < 0.001) were significantly associated with the dependent variable “diastolic blood pressure”. The association between PD ≥ 4 mm and diastolic blood pressure remained significant (P = 0.006) even after adjusting for potential confounders BMI-sds, age, gender, mother’s country of birth, BOP >25%, IL-6, IL-8, Leptin, MCP-1, TSH and total cholesterol in the multiple regression analysis.ConclusionIn conclusion, this study indicates an association between pathological periodontal pockets and diastolic blood pressure in obese adolescents. The association was unaffected by other risk markers for cardiovascular events or periodontal disease. The results call for collaboration between pediatric dentists and medical physicians in preventing obesity development and its associated disorders.

Relationship between hypothyroidism and periodontitis: A scoping review

“…In addition, periodontal measurements in the excluded studies were based solely on the presence of gingival inflammation (gingivitis), and there were no measurements of pocket depth or bone levels. The study by Zeigler, Wondimu, Marcus, and Modéer () also was excluded due to use of an adolescent patient population and a definition of pocket depths greater than 3 mm as “deep.” In addition, the objective of Zeigler et al was to compare blood pressure to obesity, but the level of thyroid‐stimulating hormone (TSH) was used only as an adjusted confounder for that comparison. Consequently, TSH levels could not be directly assessed to measure the effect of hypothyroidism on periodontal disease.…”

Oral consequences of obesity and metabolic syndrome in children and adolescents

“…32 The study by Zeigler et al showed no correlation between BMI, dietary habits, hygiene, and oral hygiene in obese adolescents. 33 However, obese teenagers with gingival pocket depth (PD) ≥4 mm had significantly more points with BOP ≥ 25% and considerably higher systolic blood pressure than obese teenagers with PD < 4 mm. 33 This data may confirm the assumption that periodontal disease in obese adolescents has an impact on organ complications of obesity, leading to the development of arteriosclerosis and cardiovascular diseases.…”

“…33 However, obese teenagers with gingival pocket depth (PD) ≥4 mm had significantly more points with BOP ≥ 25% and considerably higher systolic blood pressure than obese teenagers with PD < 4 mm. 33 This data may confirm the assumption that periodontal disease in obese adolescents has an impact on organ complications of obesity, leading to the development of arteriosclerosis and cardiovascular diseases. Also Scorzetti et al noted a significant increase in the values of periodontal disease indicators, including the oral hygiene index (OHI), approximal plaque index (API) and BOP, and a higher percentage of pockets with a probing depth exceeding 4 mm in obese children aged 6-13 compared to peers with normal body weight.…”

Th1‐type immune responses to Porphyromonas gingivalis antigens exacerbate angiotensin II‐dependent hypertension and vascular dysfunction

“…These cells could migrate to the vasculature and kidneys and alter vascular function, promote renal damage and contribute to hypertension. In line with this hypothesis, several studies show the coexistence of periodontal and cardiovascular disease in patients (Tsakos et al ., ; Ricardo et al ., ; Schmitt et al ., ; Winning et al ., ; Zeigler et al ., ; Hansen et al ., ). However, most of these studies suffer from clinical limitations related to confounding factors.…”