Dental News - Scientists find link between mouthwash use and raised blood pressure

Dental Tribune International

Thu. 28. March 2019

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HOUSTON, U.S.: A balanced oral microbiome can contribute to good cardiovascular health by converting dietary nitrate into nitric oxide (NO), a signaling molecule that helps maintain normal blood pressure. Now, a new study has suggested that chlorhexidine, an antiseptic substance found in mouthwash, may kill NO-producing bacteria and raise systolic blood pressure.

The researchers used 16S rRNA gene sequencing and analysis to examine whether using chlorhexidine antiseptic mouthwash twice a day for one week would change the oral bacterial communities and blood pressure levels in 26 healthy individuals. They collected samples of the participants’ saliva and tongue scrapings and measured their blood pressure at baseline as well as seven, ten and 14 days later.

The results indicated that using chlorhexidine twice a day was associated with a significant increase in systolic blood pressure and that recovery from use resulted in an enhancement in nitrate-reducing bacteria on the tongue. Individuals with relatively high levels of bacterial nitrite reductases had lower resting systolic blood pressure.

“The demonstration that the presence of NO-producing bacteria in the oral cavity can help maintain normal blood pressure gives us another target to help the more than 100 million Americans living with high blood pressure,” said lead researcher Dr. Nathan S. Bryan, an adjunct professor in the Department of Molecular and Human Genetics at the Baylor College of Medicine in Houston. “Two out of three patients prescribed high blood pressure medication do not have their blood pressure adequately managed,” he added. “None of the [current] drugs for management of hypertension are targeted towards these NO-producing bacteria.”

According to Bryan, owing to the widespread nature of the molecule, oral bacteria may have other profound effects on human health besides regulating blood pressure. “We know one cannot be well without an adequate amount of NO circulating throughout the body. Yet, the very first thing over 200 million Americans do each day is use an antiseptic mouthwash, which destroys the ‘good bacteria’ that help to create the NO. These once thought good habits may be doing more harm than good,” he said.

The study, titled “Frequency of tongue cleaning impacts the human tongue microbiome composition and enterosalivary circulation of nitrate,” was published online on March 1, 2019, in Frontiers in Cellular and Infection Microbiology.

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