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Association between high blood pressure and deep periodontal pockets: a nested case-referent study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology. (Family medicine and clinical epidemiology)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg. (Family medicine and clinical epidemiology)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
2007 (English)In: Upsala Journal of Medical Sciences, Supplement, ISSN 0300-9726, Vol. 112, no 1, 95-103 p.Article in journal (Refereed) Published
Abstract [en]

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 <= 90 mm Hg. Significantly more cases than referents had periodontal pockets >= 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 regulary visits at the dental clinic may give the dental care a new important role in the public health field.

Place, publisher, year, edition, pages
2007. Vol. 112, no 1, 95-103 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-10319ISI: 000253451900009OAI: oai:DiVA.org:uu-10319DiVA: diva2:38087
Available from: 2007-03-21 Created: 2007-03-21 Last updated: 2012-03-26Bibliographically approved
In thesis
1. Dental Health Care Cooperating with Primary Health Care as a Resource in Early Case Finding of Patients with Diabetes or Hypertension
Open this publication in new window or tab >>Dental Health Care Cooperating with Primary Health Care as a Resource in Early Case Finding of Patients with Diabetes or Hypertension
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Objectives To investigate if there is an association between dental health status and high blood pressure, to test the effectiveness of screening for high blood pressure and high blood glucose performed by the dental health care in collaboration with primary health care and to investigate the direct costs for this type of screening organisation.

Study population and methods In Paper I 54 subjects with known hypertension and 141 with a high blood pressure in the dental office were compared with matched controls. In Paper II 1,149 subjects were screened for hypertension and in Paper III 1,568 subjects were screened for diabetes in dental care. Follow up was performed in co-operating primary health care centres. In paper IV the direct costs for screening and follow-up were calculated.

Results There was a significant association between deep periodontal pockets and high blood pressure, even when the influence of age, sex, smoking and number of teeth was taken into account. Among those being screened for high blood pressure and high blood glucose 20.6% and 9.9% respectively were referred to primary health care, and a hypertension or a diabetes diagnosis was found in 32.1% and 5.8% of those screening positive. For every 18th subject screened a hypertension case was found (“numbers needed to screen” (NNS)), and for every 196th a diabetes case. NNS for combined hypertension and diabetes screening was 15. The total direct costs for screening and follow up per diagnosis found were 5,298 SEK for hypertension, 19,100 SEK for diabetes, and  4,116 SEK for combined blood pressure and blood glucose screening.

Conclusions There was an association between dental health and hypertension. Screening for hypertension was highly efficient, while screening for diabetes was less so, because it is a less prevalent condition. Screening for both conditions appears to be the most efficient type of screening.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 72 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 742
Keyword
Screening, dental care, primary health care, high blood pressure, high blood glucose
National Category
Medical and Health Sciences
Research subject
Family Medicine
Identifiers
urn:nbn:se:uu:diva-167527 (URN)978-91-554-8277-0 (ISBN)
Public defence
2012-03-30, Rudbeckssalen, Dag Hammarskjölds väg 20, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2012-03-08 Created: 2012-01-30 Last updated: 2012-03-29Bibliographically approved

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http://informahealthcare.com/doi/abs/10.3109/2000-1967-099

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Engström, SevekHögberg, HansSvärdsudd, Kurt F

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