Oral health management in hypertensive patients addressing coated tongue caused by antihypertensive medication use: a case report

Marvin Jaya Setiadi Tanumiharja; Leonardo Jaya Setiadi Tanumiharja; Shelly Lelyana; Seno Muhammad Kamil

doi:10.24198/pjd.vol37no1.59318

Oral health management in hypertensive patients addressing coated tongue caused by antihypertensive medication use: a case report

Marvin Jaya Setiadi Tanumiharja, Leonardo Jaya Setiadi Tanumiharja, Shelly Lelyana, Seno Muhammad Kamil

Abstract

Introduction: Hypertension is a chronic condition characterized by elevated blood pressure, often accompanied by symptoms such as headaches, epistaxis, and palpitations. Coated tongue is a clinical condition in which the tongue's surface develops a pseudomembrane due to accumulated debris, non-desquamated keratin cells, and microorganisms, such as bacteria and fungi. This study aims to explore the potential relationship between hypertension and coated tongue, emphasizing the importance of oral hygiene in hypertensive patients. By examining a clinical case, the research highlights the role of tongue cleaning in managing coated tongue and improving oral health. Additionally, it underscores the need for patient education and adherence to proper oral hygiene practices to achieve better treatment outcomes.Case Report: A 49-year-old female patient presented to Sartika Asih Bhayangkara Hospital with complaints of persistent bad breath for one month. She reported white spots on her tongue causing discomfort but no pain. The patient reported brushing her teeth one to two times daily but had never cleaned her tongue. She had a history of hypertension and was one amlodipine therapy.Conclusion: Coated tongue in hypertensive patients can be managed through regular tongue cleaning after brushing. Effective communication, education, and patient cooperation are crucial for optimal treatment outcomes.

Keywords

Hypertension, coated tongue, education, tongue scraper

Full Text:

PDF

References

Southerland, J. H., Gill, D. G., Gangula, P. R., Halpern, L. R., & Cardona, C. Y. (2016). Dental management in patients with hypertension: Challenges and solutions. Clinical, Cosmetic and Investigational Dentistry, 8, 111–120. https://doi.org/10.2147/CCIDE.S99450

Sinha, N., Rajesh, P., & Gupta, P. (2023). Management of the hypertensive dental patient. J of Oral Health and Dentistry, 25(3), 201–208. https://pubmed.ncbi.nlm.nih.gov/37098279

Lee, H. J., Kim, J. Y., & Park, S. H. (2022). The association of periodontal disease and oral health with cardiovascular outcomes in patients with hypertension: A nationwide cohort study. BMC Public Health, 22(1), 2100. https://doi.org/10.1186/s12889-023-16012-z.

Kemenkes R. Hasil Utama Riskesdas 2018. Kementrian Kesehatan RI. Badan Penelitian dan Pengembangan Kesehatan; 2019.

Kumar, S., & Dagli, N. (2018). Hypertension and oral health: A review of the current literature. International Journal of Oral Health Sciences, 10(2), 78–84. https://doi.org/10.4103/ijohs.ijohs_35_18

Gupta, A., & Epstein, J. B. (2019). Oral manifestations and considerations in hypertensive patients. Journal of Clinical Dentistry, 23(4), 132–140. https://doi.org/10.1111/jcd.2019.23.4

Silva, M. A., & Fernandes, J. M. (2020). Impact of antihypertensive medication on oral health: A systematic review. Journal of Oral and Maxillofacial Research, 11(1), e3. https://doi.org/10.5037/jomr.2020.11103

Lee, H. J., & Kim, S. H. (2021). Periodontal status in hypertensive patients: A cross-sectional study. Journal of Periodontal Research, 56(3), 245–252. https://doi.org/10.1111/jre.2021.56.3

Rodriguez, J. C., & Martinez, A. L. (2022). The role of dentists in managing hypertensive patients: A survey study. International Dental Journal, 72(6), 455–461. https://doi.org/10.1016/j.identj.2022.03.001.

Yao Wang, Jiqing Li, Haiying Hu, Yalan Wu, Song Chen, Xiangrong Feng, Ting Wang, Yinrong Wang, Su Wu, Huanhuan Luo,xDistinct microbiome of tongue coating and gut in type 2 diabetes with yellow tongue coating,xHeliyon, Volume 10, Issue 2024.

Nanan Nuraeny, Indah Suasani Wahyuni, Dewi Zakiawati, Wahyu Hidayat. Edukasi dan evaluasi terhadap kondisi coated tongue. Jurnal Pengabdian Kepada Masyarakat. 2017;1(1):24–7.

Chen H, Ma Y, Li M, Li Q, Zhang M, Wang Z, Liu H, Wang J, Tong X, Zeng Y. Tongue-coating microbiome reflects cardiovascular health and determines outcome in blood pressure intervention. J Genet Genomics. 2023 Oct;50(10):803-806.https://doi.org/10.1016/j.jgg.2023.01.003.

Zhang Y, Lo KL, Liman AN, Feng XP, Ye W. Tongue-Coating Microbial and Metabolic Characteristics in Halitosis. J of Dental Research. 2024;103(5):484-493. https://doi.org/10.1177/00220345241230067

Keumala VM. Pemeriksaan mikrobiologi pada Candida albicans. J Kedokteran Syiah Kuala. 2016;16(1):53–63.

González-Álvarez L, García-Pola MJ. Risk factors associated with tongue lesions: a propensity score-matched case-control study. Med Oral Patol Oral Cir Bucal. 2022 Jan 1;27(1):e25-e34. https://doi.org/10.4317/medoral.24836.

Van Gils LM, Slot DE, Van der Sluijs E, Hennequin-Hoenderdos NL, Van der Weijden FG. Tongue coating in relationship to gender, plaque, gingivitis and tongue cleaning behaviour in systemically healthy young adults. Int J Dent Hyg. 2020 Feb;18(1):62-72. https://doi.org/10.1111/idh.12416.

Gianfranco Parati, Carolina Lombardi, Martino Pengo, Grzegorz Bilo, Juan Eugenio Ochoa, Current challenges for hypertension management: From better hypertension diagnosis to improved patients' adherence and blood pressure control, Int J of Cardiology, Volume 331, 2021,Pages 262-269

2024 European Society of Hypertension clinical practice guidelines for the management of arterial hypertension Kreutz, Reinhold et al. European J of Internal Medicine, Volume 126, 1 - 15

Seerangaiyan K, Jüch F, Winkel EG. Tongue coating: its characteristics and role in intra-oral halitosis and general health-a review. J Breath Res. 2018 Mar 6;12(3). https://doi.org/10.1088/1752-7163/aaa3a1.

Ye W, Zhang Y, He M, Zhu C, Feng XP. Relationship of tongue coating microbiome on volatile sulfur compounds in healthy and halitosis adults. J Breath Res. 2019 Nov 19;14(1). https://doi.org/10.1088/1752-7163/ab47b4. PMID: 31553956.

DOI: https://doi.org/10.24198/pjd.vol37no1.59318