Oral health, dysbiotic oral microbiome, and hypertension in Sub-Saharan Africa: a scoping review of current evidence

Background: Hypertension (HTN) is a significant public health concern globally, with Sub-Saharan Africa (SSA) bearing a considerable burden. Dysbiosis of the oral microbiome may play a role in the pathogenesis of HTN, with a scarcity of evidence in SSA. The aim of this review was to explore the existing literature on the influence of oral health and dysbiotic oral microbiomes on the development of HTN in SSA countries. Methods: A comprehensive search across electronic databases, including PubMed, Google Scholar, Scopus, ScienceDirect, and Web of Science, was conducted from 2000 up to December 2025. Studies involving SSA populations and addressing the role of the oral microbiome in HTN were included. Results: The review identified 12 studies investigating oral microbiota dysbiosis and its association with HTN in six SSA countries (South Africa, Nigeria, Tanzania, Senegal, Ghana, and Cameroon). Of these, 10 studies assessed periodontal diseases using clinical indices as a proxy for dysbiosis, 1 study assessed dental caries, while only a single study performed direct microbial analysis (using 16S rRNA gene sequencing). Eight studies reported quantitative effect estimates: odds ratios for the association between periodontal disease or gingivitis and HTN ranged from 1.5 to 4.30 (all P < 0.05), while one study reported an association between dental caries and HTN (odds ratio, 0.72–0.73). The reported prevalence of HTN ranged between 19.7 and 91.8%. Conclusion: This scoping review finds that most available evidence from SSA supports an association between periodontal disease and HTN. However, direct evidence regarding the oral microbiome itself remains very limited, with only one study performing species-level microbial analysis.