Oral Health and Its Association with Systolic Blood Pressure Among Women in Rural Nepal: A Cross-Sectional Study

Background: Oral diseases are a significant yet under-recognized public health issue, particularly in low-resource settings. In Nepal, rural women face health inequities and limited access to general and oral healthcare. Emerging evidence suggests a bidirectional relationship between hypertension and poor oral health, but data from South Asia are limited. The object of the current study was to assess the oral health status and examine the potential associations of systolic blood pressure (SBP) with caries experience (Decayed, Missing, and Filled Teeth (DMFT)), and severe periodontitis, among women in rural Nepal. Methods: This cross-sectional study included 691 non-pregnant women from the Kavre District, Nepal, recruited in 2019 as part of a larger health survey. Blood pressure was measured using standardized protocols and clinical oral assessments were conducted using the WHO Oral Health Assessment Form for Adults. Associations between SBP and oral health outcomes were analyzed using negative binomial and logistic regression models, adjusting for sociodemographic, behavioral, and biological factors. Results: The mean age of the participants was 48.4 ± 11.7 years. Decayed teeth were present in 58.6% of the women, only five participants (0.6%) had any restorative dental treatment, and the overall mean DMFT index was 5.07 ± 6.04. Bleeding on probing was observed in 81.6% of the participants, and 12.7% presented with severe periodontitis. Hypertension affected 29.8% of the women. While unadjusted analyses showed associations between SBP and both DMFT and severe periodontitis, these associations were not significant after adjusting for variables such as age, body mass index, smoking, vitamin D levels, and other factors. Conclusions: This study shows a relatively high burden of oral health issues among rural Nepalese women along a high prevalence of hypertension. Although elevated SBP appeared to be linked with poor oral health, adjusted analyses suggest that shared risk factors, such as age, comorbidities, and behavioral practices, may play a more prominent role in this population. These findings underscore the need for integrated health strategies addressing both oral and systemic health in marginalized populations.