Influence of mouth rinse use on the enterosalivary pathway and blood pressure regulation: A systematic review.
Level 1 - systematic review of randomized trials
Systematic review of human crossover trials and animal controlled studies
PubMed 31542940 · doi:10.1080/10408398.2019.1665495
What was done
A systematic review (PROSPERO CRD42019125081) searched PubMed and EBSCOhost for peer-reviewed human and animal studies evaluating the effect of antibacterial mouth rinses on salivary or plasma nitrate/nitrite concentrations and blood pressure. Study quality was evaluated independently by the authors using Academy of Nutrition and Dietetics tools.
What was found
Eight studies (5 human crossover trials and 3 controlled animal studies published between 2009 and 2016) were analyzed. All 5 human studies showed reduced salivary nitrite concentrations, 3 of 5 reported reduced plasma nitrite, and 4 of 5 reported an increase in blood pressure compared to control. Among animal studies, 2 of 3 reported decreased plasma nitrite and increased blood pressure. Specific numerical effect sizes were not reported in the abstract.
Why it matters
Oral commensal bacteria are required to convert dietary nitrate into nitrite, an essential step in generating nitric oxide for vasodilation. Routine use of antiseptic mouth rinses can eliminate these bacteria and acutely elevate blood pressure.
Limits
The total evidence base is small, comprising only eight studies with mixed formulations and strengths. Long-term cardiovascular outcomes, clinical hypertension risk, and participant-level sample sizes were not reported in the abstract.
Cited by
- supports Oral bacteria reduce dietary inorganic nitrates found in vegetables like beets and arugula into nitrites, which subsequently enter the nitric oxide pathway to promote vasodilation.