Antithrombotic use was independently associated with both post-extraction bleeding and periodontal disease-related gingival bleeding in older patients, whereas increased systolic blood pressure was independently associated with periodontal bleeding in both sexes and with post-extraction bleeding in males.
Key Findings
Results
Antithrombotic use was independently associated with both post-extraction bleeding (PEB) and periodontal disease-related gingival bleeding (PDB) in older patients of both sexes.
Multivariable logistic regression analyses were performed in the O-group (≥60 years) due to limited case numbers in younger age groups.
The association held for both males and females in the older age group.
The study included 216 patients with PEB, 119 with PDB, and 81 with other bleeding, totaling 416 bleeding patients.
Antithrombotic use was described as being 'independently associated' with both bleeding conditions in the regression analyses.
Results
Increased systolic blood pressure was independently associated with periodontal disease-related gingival bleeding in both sexes and with post-extraction bleeding in males.
Systolic blood pressure (SBP) was measured at the dental out-of-hours clinic visit.
The association between increased SBP and PDB was found in both males and females in the O-group (≥60 years).
The association between increased SBP and PEB was found in males but not independently in females.
The authors note that increased SBP was associated with PEB 'to a lesser extent' compared to PDB.
Results
Hypertension (as a treated condition) was independently associated with periodontal disease-related gingival bleeding only in females, not in males.
A distinction was made between measured systolic blood pressure and a diagnosis of treated hypertension as separate variables.
Hypertension was not independently associated with post-extraction bleeding in either sex.
Both Fisher's exact test and multivariable logistic regression were used to assess prevalence of systemic factors.
The finding highlights that the acute blood pressure reading and a prior hypertension diagnosis may have different associations with bleeding type and patient sex.
Results
Diabetes mellitus was not independently associated with either post-extraction bleeding or periodontal disease-related gingival bleeding.
Diabetes mellitus was included as one of the systemic factors collected retrospectively from patient records.
Multivariable logistic regression in the O-group (≥60 years) showed no independent association for diabetes mellitus with PEB or PDB.
This was true for both sexes in the older age group.
The result contrasts with the significant associations found for antithrombotic use and systolic blood pressure.
Methods
The study retrospectively categorized 416 dental out-of-hours clinic patients presenting with bleeding into three groups: post-extraction bleeding, periodontal disease-related gingival bleeding, and other bleeding.
Groups comprised 216 patients with PEB, 119 with PDB, and 81 with other bleeding (Control group).
Patients were further stratified by sex and age: young (Y)-group (20–39 years), middle (M)-group (40–59 years), and older (O)-group (≥60 years).
Data collected included systolic and diastolic blood pressure, treated hypertension prevalence, antithrombotic use, and diabetes mellitus.
Mean blood pressure values were compared using Welch's t-test and prevalence of systemic factors using Fisher's exact test.
Multivariable logistic regression was limited to the O-group due to insufficient case numbers in the Y and M-groups.
What This Means
This research suggests that patients who show up to emergency dental clinics with bleeding after a tooth extraction or from gum disease are more likely to be taking blood-thinning medications (antithrombotics) and to have elevated blood pressure compared to patients presenting for other dental emergencies. The study looked at 416 patients visiting a dental out-of-hours clinic and found these associations were particularly clear in patients aged 60 and older. Notably, a high systolic blood pressure reading at the time of the visit was linked to gum disease-related bleeding in both men and women, and to post-extraction bleeding in men specifically.
Interestingly, while blood pressure measured on the day of the visit mattered, having a formal diagnosis of treated hypertension was only independently linked to gum bleeding in women—not men—and was not linked to post-extraction bleeding at all. Diabetes, despite being a condition often associated with oral health problems, was not independently associated with either type of bleeding in the analysis. These findings point to blood thinners and elevated blood pressure as the most consistently important systemic risk factors for acute oral bleeding in older dental patients.
This research suggests that dental professionals treating patients with acute oral bleeding—especially older patients—should routinely assess blood pressure and ask about antithrombotic medication use. Identifying these systemic factors could help clinicians better manage bleeding complications and determine when medical consultation or additional precautions may be needed. The study's retrospective design and single-clinic setting are limitations, but the findings reinforce the importance of a whole-body health perspective even in emergency dental care.
Iijima Y, Yamada M, Hino S, Sano M, Horie N, Kaneko T. (2026). Blood Pressure and Systemic Risk Factors in Patients Presenting With Post-Extraction and Periodontal Bleeding at a Dental Out-of-Hours Clinic.. Clinical and experimental dental research. https://doi.org/10.1002/cre2.70446