Normal Blood Pressure, Periodontitis
Conditions
Brief summary
Blood pressure control is crucial for individuals' wellbeing. However, many daily aspects such as diet could impair blood pressure control. In addition, many people living under different conditions in different countries are affected by some kind of gum disease. These people experience gingival bleeding, bad breath, teeth mobility and pain. Throughout gum disease development the number of oral germs in the mouth increases including their levels in tongue surface. Oral bacterial are able to convert nitrate widely found in food in nitrite which influences blood pressure. Frequently treatment of gum diseases general combines manual instrumentation with mouthwashes. However, it has been suggested that reduction of oral bacteria by mouthwashes, especially chlorhexidine, is accompanied by decreased conversion of nitrate to nitrite and that this minor nitrite availability would increase blood pressure. Therefore, this is a point to be clarified for patients, physicians and dentists. This study will investigate the relation between treatment with mouthwashes and blood pressure of patients with destructive gum disease based on nitrite levels in saliva, bacterial levels in tongue and values of arterial blood pressure which will be monitored over 6 months. In addition, usual clinical parameters and alteration of oral cells' DNA will be also monitored overtime. Patients will be treated under local anesthesia and manual instrumentation within 24 hours. They will receive oral care products too. There will be 3 treatment groups (manual instrumentation + chlorhexidine mouthwash \[2 times a day for 3 weeks\], manual instrumentation + placebo mouthwash \[2 times a day for 3 weeks\] and manual instrumentation + no mouthwash) and 2 dental appointments before treatment. After treatment, patients will be examined at 7, 14, 21, 90 and 180 days. Saliva, plaque and cell sampling will be fast and by no invasive methods.
Interventions
DRUG0.12% chlorhexidine digluconate mouthwash
0.12% chlorhexidine digluconate mouthwash (20mL/60 seconds/ 2 times a day/ 3 weeks).
PROCEDUREPeriodontal instrumentation
Full-mouth scaling and root planing with manual curettes within 24 hours in two sections 1 hour each.
DRUGPlacebo mouthwash
placebo mouthwash (20mL/60 seconds/ 2 times a day/ 3 weeks).
Sponsors
Conselho Nacional de Desenvolvimento Científico e Tecnológico
University of Taubate
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
35 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
* 12 natural teeth; chronic periodontitis stages II and III; no systemic medication; non smokers; normal blood pressure; no mouthwash regular use; antibiotics \> 3 months prior to study; dental treatment \> 3 months prior to study.
Exclusion criteria
\- known alergy to chlorhexidine; removable prosthodontics apparatus; pregnant and breast feeding women.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy - comparative tongue bacterial counts | Baseline and 3 months | Changes of Veillonella, Streptococcus, Neisseria, Fusobacterium and Acytinomyces counts in samples from tongue dorsal |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Safety - comparative nitrite levels in saliva | Baseline and 3 months | Differences in mean nitrite levels from saliva samples pre- and post-treatment |
| Safety - Percentage of hypertension episodes | Baseline and 3 months | Changes in the percentage of hypertension episode |
| Safety - status of DNA methylation in oral cells | Baseline and 3 months | Mean changes of DNA methylation statuses in oral cells |
| Efficacy - Percentage of periodontal pockets | Baseline and 6 months | Changes in the percentage of deep periodontal pockets |
Countries
Brazil
Outcome results
None listed