Assessing smartphone-derived heart rate variability as an indicator of general and oral health: an exploratory study

Authors

DOI:

https://doi.org/10.5327/2525-5711.268

Keywords:

Heart Rate Variability, Oral health, Periodontal Diseases, Tooth loss, Heart rate

Abstract

Objective: This study aimed to investigate the feasibility and effectiveness of using smartphone-derived heart rate variability (HRV) as a diagnostic tool for assessing both general and oral health conditions.

Methods: An exploratory and cross-sectional study was conducted. HRV was recorded through smartphone photoplethysmography (PPG). Were searched associations between HRV and the American Society of Anesthesiologists (ASA) risk classification in dentistry, tooth loss (TL), dental maintenance and rehabilitation status (DMRS), and periodontal disease (PD). To confirm the reliability of signal acquisition pattern by PPG method via smartphone, heart rate (HR) was compared using four additional devices.

Results: The HR derived from the smartphone demonstrated reliability comparable to traditional monitoring devices. Significant associations were found between higher HRV scores with better oral health outcomes. Smartphone-derived HRV was able to detect comorbidity with 68.3% of sensitivity and 61.5% of specificity.

Conclusion: This study underscores the potential of smartphone-derived HRV as a complementary diagnostic tool for evaluating both general and oral health conditions. The findings reveal discernible associations between HRV and the ASA classification for risk in dentistry and with the studied oral health parameters. HR derived from smartphone is reliable when compared with traditional cardiac monitoring devices.

Author Biography

Luiz Felipe Manosso Guzzoni, University of Ponta Grossa – Ponta Grossa (PR), Brazil.

 

 

References

Owens AP. The role of heart rate variability in the future of remote digital biomarkers. Front Neurosci. 2020;14:582145. https://doi.org/10.3389/fnins.2020.582145

Turcu AM, Ilie AC, Ștefăniu R, Țăranu SM, Sandu IA, Alexa-Stratulat T, et al. The impact of heart rate variability monitoring on preventing severe cardiovascular events. Diagnostics (Basel). 2023;13(14):2382. https://doi.org/10.3390/diagnostics13142382

McGovern J, Leadbitter S, Miller G, Hounat A, Kamande I, Dolan RD, et al. The relationship between heart rate variability and TNM stage, co-morbidity, systemic inflammation and survival in patients with primary operable colorectal cancer. Sci Rep. 2023;13(1):8157. https://doi.org/10.1038/s41598-023-35396-x

Nicolini P, Malfatto G, Lucchi T. Heart rate variability and cognition: a narrative systematic review of longitudinal studies. J Clin Med. 2024;13(1):280. https://doi.org/10.3390/jcm13010280

Gullett N, Zajkowska Z, Walsh A, Harper R, Mondelli V. Heart rate variability (HRV) as a way to understand associations between the autonomic nervous system (ANS) and affective states: a critical review of the literature. Int J Psychophysiol. 2023; 192:35-42. https://doi.org/10.1016/j.ijpsycho.2023.08.001

Li K, Cardoso C, Moctezuma-Ramirez A, Elgalad A, Perin E. Heart rate variability measurement through a smart wearable device: another breakthrough for personal health monitoring? Int J Environ Res Public Health. 2023;20(24):7146. https://doi.org/10.3390/ijerph20247146

Vanderlei LCM, Pastre CM, Hoshi RA, Carvalho TD, Godoy MF. Basic notions of heart rate variability and its clinical applicability. Rev Bras Cir Cardiovasc. 2009;24(2):205-17. https://doi.org/10.1590/s0102-76382009000200018

Chinthakanan S, Laosuwan K, Boonyawong P, Kumfu S, Chattipakorn N, Chattipakorn SC. Reduced heart rate variability and increased saliva cortisol in patients with TMD. Arch Oral Biol. 2018;90:125-9. https://doi.org/10.1016/j.archoralbio.2018.03.011

Drury RL, Simonetti SA. Heart rate variability in dental science. Front Med (Lausanne). 2019;6:13. https://doi.org/10.3389/fmed.2019.00013

Natarajan A, Pantelopoulos A, Emir-Farinas H, Natarajan P. Heart rate variability with photoplethysmography in 8 million individuals: a cross-sectional study. Lancet Digit Health. 2020;2(12):e650-e657. https://doi.org/10.1016/S2589-7500(20)30246-6

Guede-Fernandez F, Ferrer-Mileo V, Ramos-Castro J, Fernandez-Chimeno M, Garcia-Gonzalez MA. Real time heart rate variability assessment from Android smartphone camera photoplethysmography: postural and device influences. Annu Int Conf IEEE Eng Med Biol Soc. 2015;2015:7332-5. https://doi.org/10.1109/EMBC.2015.7320085

Ferrer-Mileo V, Guede-Fernandez F, Fernandez-Chimeno M, Ramos-Castro J, Garcia-Gonzalez MA. Accuracy of heart rate variability estimation by photoplethysmography using an smartphone: processing optimization and fiducial point selection. Annu Int Conf IEEE Eng Med Biol Soc. 2015;2015:5700-3. https://doi.org/10.1109/EMBC.2015.7319686

De Ridder B, Van Rompaey B, Kampen JK, Haine S, Dilles T. Smartphone apps using photoplethysmography for heart rate monitoring: meta-analysis. JMIR Cardio. 2018;2(1):e4. https://doi.org/10.2196/cardio.8802

Shabaan M, Arshid K, Yaqub M, Jinchao F, Zia MS, Bojja GR, et al. Survey: smartphone-based assessment of cardiovascular diseases using ECG and PPG analysis. BMC Med Inform Decis Mak. 2020;20(1):177. https://doi.org/10.1186/s12911-020-01199-7

Holmlund A, Holm G, Lind L. Number of teeth as a predictor of cardiovascular mortality in a cohort of 7,674 subjects followed for 12 years. J Periodontol. 2010;81(6):870-6. https://doi.org/10.1902/jop.2010.090680

Yang B, Petrick JL, Abnet CC, Graubard BI, Murphy G, Weinstein SJ, et al. Tooth loss and liver cancer incidence in a Finnish cohort. Cancer Causes Control. 2017;28(8):899-904. https://doi.org/10.1007/s10552-017-0906-y

Maisonneuve P, Amar S, Lowenfels AB. Periodontal disease, edentulism, and pancreatic cancer: a meta-analysis. Ann Oncol. 2017;28(5):985-95. https://doi.org/10.1093/annonc/mdx019

Scherer RX, Scherer WJ. U.S. state correlations between oral health metrics and Alzheimer's disease mortality, prevalence and subjective cognitive decline prevalence. Sci Rep. 2020;10(1):20962. https://doi.org/10.1038/s41598-020-77937-8

Da Silva JD, Ni SC, Lee C, Elani H, Ho K, Thomas C, et al. Association between cognitive health and masticatory conditions: a descriptive study of the national database of the universal healthcare system in Japan. Aging (Albany NY). 2021;13(6):7943-52. https://doi.org/10.18632/aging.202843

Altamura S, Del Pinto R, Pietropaoli D, Ferri C. Oral health as a modifiable risk factor for cardiovascular diseases. Trends Cardiovasc Med. 2023;34(4):267-75. https://doi.org/10.1016/j.tcm.2023.03.003

Abraham-Inpijn L, Russell G, Abraham DA, Bäckman N, Baum E, Bullón-Fernández P, et al. A patient-administered Medical Risk Related History questionnaire (EMRRH) for use in 10 European countries (multicenter trial). Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(5):597-605. https://doi.org/10.1016/j.tripleo.2007.09.032

Cardoso RB, Faria KW, Schmidt KA, Campagnoli EB, Claudino M, Bortoluzzi MC. Is there any association between cognitive decline with the oral health condition? Res Soc Dev. 2021;10(5):e42410514911. https://doi.org/10.33448/rsd-v10i5.14911

Eke PI, Page RC, Wei L, Thornton-Evans G, Genco RJ. Update of the case definitions for population-based surveillance of periodontitis. J Periodontol. 2012;83(12):1449-54. https://doi.org/10.1902/jop.2012.110664

Ekuni D, Takeuchi N, Furuta M, Tomofuji T, Morita M. Relationship between malocclusion and heart rate variability indices in young adults: a pilot study. Methods Inf Med. 2011;50(4):358-63. https://doi.org/10.3414/ME10-01-0045

Santana MDR, Pita Neto IC, Martiniano EC, Monteiro LRL, Ramos JLS, Garner DM, et al. Non-linear indices of heart rate variability during endodontic treatment. Braz Oral Res. 2016;30:S1806-83242016000100220. https://doi.org/10.1590/1807-3107BOR-2016.vol30.0029

Le SH, Tonami K, Umemori S, Nguyen LT, Ngo LTQ, Mataki S. The potential of heart rate variability for exploring dental anxiety in mandibular third molar surgery. Int J Oral Maxillofac Surg. 2018;47(6):809-15. https://doi.org/10.1016/j.ijom.2018.01.019

Yamashita K, Uto A, Uchino M, Shidou R, Kibe T, Sugimura M. Sympathetic nerve activity during tooth extraction in women is related to dental anxiety immediately after surgery. J Oral Maxillofac Surg. 2021;79(11):2268.e1-2268.e5. https://doi.org/10.1016/j.joms.2021.06.019

Padley JR, Ben-Menachem E. Low pre-operative heart rate variability and complexity are associated with hypotension after anesthesia induction in major abdominal surgery. J Clin Monit Comput. 2018;32(2):245-52. https://doi.org/10.1007/s10877-017-0012-4

Tada A, Miura H. Association of mastication and factors affecting masticatory function with obesity in adults: a systematic review. BMC Oral Health. 2018;18(1):76. https://doi.org/10.1186/s12903-018-0525-3

Lin CS, Chang WJ, Fuh JL. Lower masticatory function relates to cognitive health and intrinsic brain network in older adults. Oral Dis. 2023;29(7):2895-906. https://doi.org/10.1111/odi.14487

Downloads

Published

2024-10-23

How to Cite

1.
Guzzoni LFM, Soto VC, Pereira VL, de Lima M, dos Santos FA, Bortoluzzi MC. Assessing smartphone-derived heart rate variability as an indicator of general and oral health: an exploratory study. J Oral Diagn [Internet]. 2024 Oct. 23 [cited 2025 Jan. 23];9. Available from: https://joraldiagnosis.com/revista/article/view/268

Issue

Section

Original Article