Prehypertension and undiagnosed hypertension in a sample of dental school female patients.

OBJECTIVE: This study was conducted to assess prevalence of hypertension and prehypertension in a sample of female dental patients. METHODS: A total of 208 consecutive female patients aged ≥ 18 years provided information about sociodemographics, history of hypertension and other systemic diseases, antihypertension medication use and smoking history. Two blood pressure measurements were taken by a dentist and the average measurement was utilized in the present analysis. RESULTS: The mean age of the study sample was 38 (±13) years. Thirty-seven per cent of the sample had prehypertension (ranging between 120/80 and 139/89 mmHg). High blood pressure (HBP) measurement (≥140/90 mmHg) was recorded on 18% of the study population. Of those, 66% were unaware of their HBP prior to their dental visit (represent 12% of the study sample). The mean systolic and diastolic blood pressure of those with elevated blood pressure were 154 (±16) and 94 (±12), respectively. Furthermore, 26% of those 30 years of age or older had HBP measurements. History of hypertension was reported by 13% of the study sample. Of those, 48% had HBP measurement. The use of antihypertension medications was reported by 10%. CONCLUSIONS: There is a high prevalence of undiagnosed hypertension and prehypertension in the present sample. These results underscore the importance of routine blood pressure measurements in the dental clinics.

Periodontal therapy reduces the severity of active rheumatoid arthritis in patients treated with or without tumor necrosis factor inhibitors.

BACKGROUND: Rheumatoid arthritis (RA) and periodontitis are common chronic inflammatory conditions. Recent studies showed a beneficial effect of periodontal treatment on the severity of active RA. This study was undertaken to further examine the effect of non-surgical periodontal treatment on the signs and symptoms of RA in patients treated with or without anti-tumor necrosis factor-alpha (anti-TNF-alpha) medications. The effect of anti-TNF-alpha therapy on periodontitis also was assessed. METHODS: Forty participants diagnosed with moderate/severe RA (under treatment for RA) and severe periodontitis were randomly assigned to receive initial non-surgical periodontal therapy with scaling/root planing and oral hygiene instructions (n = 20) or no periodontal therapy (n = 20). To control RA, all participants had been using disease-modifying anti-rheumatic drugs, and 20 had also been using anti-TNF-alpha before randomization. Probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), gingival index (GI), plaque index (PI), RA disease activity score 28 (DAS28), and erythrocyte sedimentation rate (ESR) were measured at baseline and 6 weeks later. Linear mixed models were used to identify significant differences between subjects who received periodontal treatment and those who did not. RESULTS: Patients receiving periodontal treatment showed a significant decrease in the mean DAS28, ESR (P <0.001), and serum TNF-alpha (P <0.05). There was no statistically significant decrease in these parameters in patients not receiving periodontal treatment. Anti-TNF-alpha therapy resulted in a significant improvement in CAL, PD, BOP, and GI. CONCLUSIONS: Non-surgical periodontal therapy had a beneficial effect on the signs and symptoms of RA, regardless of the medications used to treat this condition. Anti-TNF-alpha therapy without periodontal treatment had no significant effect on the periodontal condition.