Poor oral health linked to higher blood pressure, worse blood pressure control

People with high blood pressure taking medication for their condition are more likely to benefit from the therapy if they have good oral health, according to new research in the American Heart Association’s journal Hypertension.

Findings of the analysis, based on a review of medical and dental exam records of more than 3,600 people with high blood pressure, reveal that those with healthier gums have lower blood pressure and responded better to blood pressure-lowering medications, compared with individuals who have gum disease, a condition known as periodontitis. Specifically, people with periodontal disease were 20 percent less likely to reach healthy blood pressure ranges, compared with patients in good oral health.

Considering the findings, the researchers say patients with periodontal disease may warrant closer blood pressure monitoring, while those diagnosed with hypertension, or persistently elevated blood pressure, might benefit from a referral to a dentist.

“Physicians should pay close attention to patients’ oral health, particularly those receiving treatment for hypertension, and urge those with signs of periodontal disease to seek dental care,” Pietropaoli said.


“Likewise, dental health professionals should be aware that oral health is indispensable to overall physiological health, including cardiovascular status,”


said study lead investigator Davide Pietropaoli, D.D.S., Ph.D., of the University of L’Aquila in Italy.

The target blood pressure range for people with hypertension is less than 130/80 mmHg according to the latest recommendations from the American Heart Association/American College of Cardiology. In the study, patients with severe periodontitis had systolic pressure that was, on average, 3 mmHg higher than those with good oral health. Systolic pressure, the upper number in a blood pressure reading, indicates the pressure of blood against the walls of the arteries. While seemingly small, the 3mmHg difference is similar to the reduction in blood pressure that can be achieved by reducing salt intake by 6 grams per day (equal to a teaspoon of salt, or 2.4 grams of sodium), the researchers said.

The presence of periodontal disease widened the gap even farther, up to 7 mmHg, among people with untreated hypertension, the study found. Blood-pressure medication narrowed the gap, down to 3 mmHg, but did not completely eliminate it, suggesting that periodontal disease may interfere with the effectiveness of blood pressure therapy.

“Patients with high blood pressure and the clinicians who care for them should be aware that good oral health may be just as important in controlling the condition as are several lifestyle interventions known to help control blood pressure, such as a low-salt diet, regular exercise and weight control,” Pietropaoli said.

While the study was not designed to clarify exactly how periodontal disease interferes with blood pressure treatment, the researchers say their results are consistent with previous research that links low-grade oral inflammation with blood vessel damage and cardiovascular risk.

Seven tips for wisdom teeth pain relief

People often decide to have their wisdom teeth removed, as they can cause painful, aching gums. How can wisdom teeth pain be relieved at home before their removal?

Wisdom teeth are the last teeth to break through the gums. They grow at the very back of a person’s mouth. There are normally four wisdom teeth in total, with one in each of the furthest corners of the top and bottom gums.

This article looks at home remedies and medical treatments to relieve the pain caused by wisdom teeth.

Contents of this article:

  1. What causes wisdom teeth pain?
  2. Treating wisdom teeth pain at home
  3. How to avoid wisdom teeth pain
  4. Outlook

What causes wisdom teeth pain?

Wisdom teeth usually emerge after all the adult teeth. They may emerge at an awkward angle, or there may not be enough room for them.

Wisdom teeth normally push their way through the gums when a person is between the ages of 17 and 21. The sensation of a tooth pushing through the gums can be painful.

In addition, there is often no room for the wisdom teeth in a person’s mouth, as the adult teeth have already developed. This lack of space may cause wisdom teeth to come through at an angle, or getting stuck and not come through fully.

When this happens, the wisdom teeth are impacted. Having impacted wisdom teeth leaves the gums vulnerable, as the surface breaks and the teeth are not fully through. Food and bacteria can get trapped in the gums and lead to several issues, including:

Treating wisdom teeth pain at home

Impacted wisdom teeth may cause pain, aches, and tenderness. Ultimately, removing the wisdom teeth can help resolve these problems.

In the meantime, there are several over-the-counter medical treatments and natural home remedies available.

1. Numbing gel

A numbing dental gel may help reduce feeling in the gums and dull the pain. These gels are available over the counter and contain the active ingredient benzocaine.

Most dental gels can be applied directly to the affected gums throughout the day. However, it is important for a person to follow the instructions included in the product. Also, it is possible to be allergic to benzocaine.

2. Ibuprofen

Ibuprofen is an over-the-counter pain relief medication that helps reduce inflammation.

Taking the recommended dose on the packet may help relieve discomfort. It can also reduce inflammation of the gums associated with wisdom teeth development.

Ibuprofen or other NSAIDs (nonsteroidal anti-inflammatory drugs) may be effective pain management until a person can see a dentist for treatment.

3. Ice pack

Applying an ice pack to the jaw can help reduce inflammation, which in turn may relieve pain. Using ice can also have a numbing effect.

A person can try holding an ice pack with a tea towel around it against their jaw for up to 15 minutes.

The ice pack can be applied off and on with 15 minute breaks until the pain has subsided.

4. Salt water rinse

Rinsing the mouth with salt water several times a day may help to reduce symptoms such as pain.

Salt water has natural disinfectant properties. A 2010 study showed that rinsing the mouth with salt water can help reduce bacteria.

Sometimes, a build-up of bacteria in the broken gums around wisdom teeth can be the cause of pain. As such, rinsing with salt water may help treat the infection and reduce the discomfort.

To make the salt water rinse, a person can dissolve a few tablespoons of salt into a glass of freshly boiled water. When the water has cooled slightly, it can be swirled around the mouth for several minutes, then spat out.

A person may want to rinse their mouth with salt water two or three times a day, or until the pain starts to reduce.

5. Cloves

Research into the effectiveness of cloves to relieve wisdom tooth pain is positive. A 2006 studyshowed that there is promise for cloves as a topical pain reliever due to their numbing effect.

To try this home remedy, a person can use a whole clove or clove oil. If using a whole clove they should:

  • place the clove over the wisdom tooth that is causing pain
  • hold it in place by closing their jaw, but without chewing
  • leave it there until the pain reduces and then spit it out

To try this remedy using clove oil, a person can:

  • put a few drops of clove oil on a ball of cotton wool
  • put the cotton wool on the wisdom tooth that is causing pain
  • hold the cotton wool in place until the pain reduces and then remove it

6. Onion

2007 study found that onions have anti-inflammatory and antimicrobial properties. These advantages of onions mean they can help reduce swelling and fight bacterial infections.

To use onions as a home remedy, a person should:

  • cut off a piece of onion
  • chew the onion on the side of the mouth that has the pain
  • keep chewing for a few minutes until pain reduces and then spit out the onion

This process allows the juice from the onion to go into the gum so that it can reduce inflammation and bacteria.

7. Tea bags

Tea bags should only be placed in the mouth when completely cooled.

2016 study found that tannins contained in tea bags have antibacterial and anti-inflammatory properties. This means tea bags may help reduce swelling and fight bacterial infections.

To use tea bags as a home remedy, a person should make a cup of tea and put the cup in the fridge with the tea bag left in it. Once the tea is cold, the tea bag can be taken out and placed inside the mouth where the pain is located.

How to avoid wisdom teeth pain

When a person’s wisdom teeth are coming through, there are practical things they can do to make it less likely that their gums become infected. These actions include:

  • Practicing good oral hygiene: Brushing teeth twice a day, flossing, and using mouthwash can help reduce the bacteria in the mouth that cause infections.
  • Drinking plenty of water: This helps to flush food and bacteria away from the teeth and gums.
  • Avoid sugary foods: Sweet foods can get stuck inside the broken gums, encouraging bacteria to grow.
Last reviewed

Dry socket: Symptoms, risk factors, and treatment.

Dr. Krape Cosmetic & Specialized Dentistry knows no one likes having a tooth extracted. Developing a complication such as dry socket after a tooth extraction may be some people’s worst nightmare.

With proper care, dry socket can be avoided. If it does develop, it is only a temporary condition that will resolve quickly with appropriate treatment.

What is dry socket?

Dry socket, also known as alveolar osteitis, is a painful complication that sometimes happens after having a tooth extracted.

After a tooth has been removed, a blood clot normally forms where the tooth was. The blood clot protects the underlying bone, tissues, and nerves as the site heals.

In cases of dry socket, the blood clot does not form or is dislodged, leaving the bone and nerves exposed.

Risk factors

Not everyone who has a tooth extracted will develop dry socket. Dentists are not certain what causes dry socket, but certain factors can increase the risk of developing it.

These factors include:

  • smoking
  • using chewing tobacco
  • use of oral contraceptives or estrogen replacement therapy
  • not following care instructions after the tooth extraction
  • poor oral hygiene
  • infections in the gum or teeth around the extraction site
  • having had dry socket in the past
  • using a drinking straw after the tooth extraction


The symptoms of dry socket are easy to identify. While no two cases of dry socket are the same, common symptoms include:

  • severe pain at the site of the extraction within 3 days
  • missing blood clot at the extraction site
  • bone visible at the extraction site
  • foul smell coming from the mouth
  • bad taste in the mouth
  • pain radiating from the tooth socket to the ear, eye, temple, or neck on the same side

While a certain amount of pain and discomfort is normal after having a tooth pulled, worsening pain or severe pain is not normal.

Anyone experiencing severe pain that does not improve after a tooth extraction should see their doctor or dentist to rule out dry socket or other complications.


A dentist or oral surgeon will likely suspect dry socket for any case of severe pain following a tooth extraction, but will also examine the person for signs of any other complications.

If necessary, the person will be sent for X-rays to rule out a bone infection, or to see if fragments of the bone or roots of the extracted tooth remain and are causing the pain.


Hands of a man and woman holding up a dental x-ray.
In some cases, a dental X-ray may be required to diagnose the cause of pain.

The treatment for dry socket consists primarily of pain management. A dentist will likely do the following to manage the symptoms:

  • flush the socket to remove any irritating debris
  • pack the socket with medicated dressings
  • prescribe pain medication

After the dentist or oral surgeon treats dry socket in the clinic, the person will need to continue with home care for several days.

Home treatment usually includes:

  • gently flushing the socket with a saline solution or medicated rinse for several days
  • continuing to take pain medication as needed

Anyone with dry socket should keep any follow-up appointments with their dentist or oral surgeon to ensure proper healing.

Management and lifestyle changes

While medical management of dry socket will help relieve pain and promote healing, self-care at home is equally as important.

A person may need to make lifestyle adjustments while treating dry socket.

These changes include:

  • stop using chewing tobacco
  • quit smoking
  • rinse mouth gently with warm water several times a day or as directed by a dentist
  • take care when brushing teeth around the affected area
  • drink plenty of clear liquids
  • avoid foods that will irritate the area
  • avoid carbonated beverages
  • avoid drinking through a straw
  • use hot and cold packs on the jaw or cheek as directed


Woman breaking a cigarette in half.
Quitting smoking can reduce the risk of developing dry socket.

Before surgery, a person having a tooth extraction can do the following things to reduce the risk of developing dry socket:

  • stop smoking or using other tobacco products, including chewing tobacco
  • research dentists and oral surgeons thoroughly to ensure they have sufficient experience in removing teeth
  • stop taking any medications that interfere with blood clotting as directed by a doctor or dentist

Immediately following the surgery, the oral surgeon will take several precautionary measures to prevent dry socket. These steps include:

  • packing the affected area with sterile gauze
  • prescribing antibacterial mouthwash or oral gel to use following the surgery
  • prescribing antibiotics if needed

At home, a person can take further steps to prevent dry socket after the surgery. These include:

  • resting following the surgery
  • avoiding sports and other activities that may knock the blood clot out of place
  • drinking lots of water after the surgery and avoiding carbonated, hot, and alcoholic drinks
  • eating only soft foods the day after the surgery
  • taking care when eating to avoid disturbing the wound until it has healed
  • avoiding any tobacco products for the first several days following surgery
  • practicing good oral hygiene as directed by the dentist or doctor
  • avoiding the area immediately around the healing wound when brushing teeth for the first day following surgery


Dry socket, though very painful, usually improves soon after beginning treatment if a person follows the doctor’s instructions.

However, a person being treated for dry socket should follow up with their doctor or dentist to ensure no other complications have developed.

After developing dry socket once, a person is at higher risk to develop it again following another tooth extraction.

Last reviewed Sun 2 July 2017 By Jenna Fletcher Reviewed by Christine A. Frank, DDS