Association of Tooth Loss with Hypertension

Abstract

Objective: Hypertension may result from changes in dietary quality and nutrient intake. This study therefore sought to determine the epidemiological association between tooth loss and hypertension in South African adults.
Methods: This is a secondary data analysis of a cross-sectional survey of a nationally representative sample of adults of aged 25 to 70 years who participated in the South African Demographic and Health Survey during 1998 (n=9,098). The primary data was collected using a validated questionnaire, which included information on past experience of tooth loss (partial or complete), use of dental services, tobacco use and other known risk factors for hypertension. Hypertension was defined as having a measured average blood pressure ≥160/95 and/or taking antihypertensive medication.
Results: The prevalence of hypertension, any tooth loss and complete edentulousness was 18.1%, 72.2% and 9.4% respectively. Tooth loss was more common among overweight/obese respondents than among those of normal body mass index (76.7% vs. 66.7%; p<0.01). Compared to the fully dentate respondents, the completely edentulous respondents presented with mean systolic and diastolic pressure that was respectively 12mmHg and 5mmHg higher. After adjusting for known risk factors for hypertension in a multiple logistic regression model, being completely edentulous remained significantly associated with hypertension (Odds ratio; 95% confidence interval = 1.35; 1.02-1.78). The estimated population attributable fraction of hypertension resulting from complete edentulousness was 10%.
Conclusions: The findings suggest that complete edentulousness is a risk indicator for hypertension in South Africa and highlights the importance of primary care practitioners’ involvement in oral health promotion.