Dentists must also be cognizant of the implications high blood pressure has for dental practice. Specific treatment recommendations include limiting dental care in patients with severe hypertension, reducing stress, and periodically monitoring blood pressure. Discover the world's research
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How should we treat patients with high blood pressure in dentists?
Dentists no doubt treat patients with hypertension and its sequelae in their practice. This article summarizes the current thinking on the diagnosis and treatment of this condition, emphasizing dental implications. The article presents common oral and systemic side effects of antihypertensive medications, and discusses how dentists can help ...
What are the side effects of dental treatment for hypertensive patients?
Dec 09, 2013 · The easiest way to treat it is to change antihypertensive medication, and lichenoid reactions are resolving after discontinuation of the responsible drug. If medication could not be changed, lichenoid reactions are treated with topical corticosteroids [ 47 ]. …
Can a dentist check your blood pressure in the office?
Aug 01, 2018 · 2. Proceed with elective dental treatment. 3. Monitor blood pressure during the appointment. Stage 2 HTN: Systolic 140+ or Diastolic 90+ 1. Retake and confirm blood pressure. 2. Monitor blood pressure during the appointment. 3. Refer patient to his or her physician for medical evaluation. Hypertension crisis: Systolic 180+ and/or Diastolic 120+ 1.
What are the treatment recommendations for hypertension (high blood pressure)?
Dentists must also be cognizant of the implications high blood pressure has for dental practice. Specific treatment recommendations include limiting dental care in patients with severe...
How do dentists manage hypertensive patients?
Dental practitioners can often be on the frontlines of prevention of hypertension by evaluating preoperative blood pressure readings, performing risk assessments, and knowing when to consider medical consultation of a hypertensive patient in a dental setting.Oct 17, 2016
How do you deal with a patient with hypertension?
Here's what you can do:Eat healthy foods. Eat a heart-healthy diet. ... Decrease the salt in your diet. Aim to limit sodium to less than 2,300 milligrams (mg) a day or less. ... Maintain a healthy weight. ... Increase physical activity. ... Limit alcohol. ... Don't smoke. ... Manage stress. ... Monitor your blood pressure at home.More items...•Jul 1, 2021
What is the significance of hypertension in the dental office?
Dental patients may experience acute high blood pressure related to a physiologic response to pain or anxiety. This is one reason that gathering information on health status and current medications in all dental patients, including those with hypertension, can be valuable.Jul 29, 2020
Why tooth extraction is contraindicated in hypertension?
If your blood pressure is too high, your dentist won't perform this procedure until you get medical care from your physician. Additionally, your oral cavity contains microorganisms, and surgical procedures like tooth extraction may increase your chances of getting postoperative infection.
What are 3 ways to treat hypertension?
AdvertisementLose extra pounds and watch your waistline. Blood pressure often increases as weight increases. ... Exercise regularly. ... Eat a healthy diet. ... Reduce sodium in your diet. ... Limit the amount of alcohol you drink. ... Quit smoking. ... Cut back on caffeine. ... Reduce your stress.More items...
What is the first line treatment for hypertension?
There are three main classes of medication that are usually in the first line of treatment for hypertension: 1. Calcium Channel Blockers (CCB) 2. Angiotensin Converting Enzyme inhibitors (ACE inhibitors or ACE-I) and Angiotensin Receptor Blockers (ARBs) 3. Diuretics.
Can dental anesthesia cause high blood pressure?
Local anesthetics contain epinephrine Epinephrine increases blood pressure in order to assist the body in reacting to emergency situations. When a dentist uses a local anesthetic or numbing cream containing epinephrine, it can cause your blood pressure to increase.Nov 13, 2019
Can dental work cause high blood pressure?
Depending on what anesthesia your dentist uses, it may contain epinephrine, a form of adrenaline that makes the numbing effects last for a more extended period of time. Epinephrine shrinks your blood vessels, which in turn could increase your blood pressure.Oct 11, 2019
Why should rapid changes in chair position during dental treatment be avoided for patients under medication for hypertension?
Dental hygienists can minimize patient/client light-headedness or fainting by avoiding rapid chair position changes. – Alpha-adrenergic blockers can result in nasal congestion, which should be considered where nasal breathing is relied upon. these possible drug side effects.May 7, 2014
Should dentists take blood pressure?
As licensed health-care professionals, it is the standard of care for dental hygienists to assess and record blood pressure on all of their patients. The reading must then be discussed with the patient as a means of helping him take charge of his overall health.Jan 16, 2017
Why is dental treatment important for hypertensive patients?
Dental treatment in hypertensive patients necessitates special attention, because any stressful procedure may increase blood pressure and trigger acute complications such as cardiac arrest or stroke. Control of pain and anxiety is very important in patients with high medical risk.
What is the recommended blood pressure for dental emergency?
It is generally recommended that emergency dental procedures be avoided in patients with a blood pressure of greater than 180/110 mmHg.
What is primary hypertension?
Primary hypertension is the term used for medium to high BP for a long time (chronic) without a known cause, which is a very common form of hypertension, comprising about 90–95% of all patients with hypertension [ 30#N#N. M. Kaplan, “Primary hypertension. from pathophysiology to prevention,” Archives of Internal Medicine, vol. 156, no. 17, pp. 1919–1920, 1996. View at: Google Scholar#N#See in References#N#].
What is the common disease in dental offices?
Hypertension is a common disease encountered in dental setting. Its wide spreading, terrible consequences, and life-long treatment require an attentive approach by dentists. Hypertension management in dental office includes disease recognition and correct measurement, knowledge of its treatment and oral adverse effects, ...
What should be included in an initial evaluation of a patient with hypertension?
Initial evaluation of each patient with hypertension should include detailed family history of cardiovascular disease and other related diseases, history of hypertension, medications, duration and antihypertensive treatment history, severity of disease, and its complications [ 61#N#J. Little, D. Fallace, C. Miller, and N. Rhodus, Dental Management of the Medically Compromised Patient, Elsevier Mosby, St Louis, Mo, USA, 8 edition, 2013.#N#See in References#N#]. Before starting dental treatment, dentist has to assess the presence of hypertension, to determine the presence of associated organ disease and determine dental treatment changes needed [ 63#N#M. Greenberg, M. Glick, and M. Ship, Burket's Oral Medicine, BC Decker Inc, 11 edition, 2008.#N#See in References#N#].
How long should a patient sit on the floor?
Patients should be seated in a chair with their feet on the floor for 5 minutes in a quiet room. Their arm should be supported at the level of the heart and an appropriately sized blood pressure cuff (cuff bladder encircling at least 80% of the arm) must be used.
Which hormone is synthesized by the kidney in response to intravascular volume depletion and hyperkalemia?
Renin , a hormone synthesized and released by the kidney in response to intravascular volume depletion and hyperkalemia, promotes the conversion of angiotensinogen (produced by the liver) to angiotensin I, which is converted to angiotensin II by the angiotensin-converting enzyme (ACE) in the lung.
What is the blood pressure level in the new guidelines?
Blood pressure categories in the new guideline are: Normal: Less than 120/80 mm Hg; Elevated: Systolic 120–129 and diastolic less than 80; Stage 1: Systolic 130–139 or diastolic between 80-89; Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;
How to check blood pressure with a mercury manometer?
1. Retake and confirm blood pressure with an alternate device , such as a mercury manometer–type sphygmomanometer. 2. If the blood pressure is unchanged, consider immediate referral of the patient to a physician or emergency room for evaluation. 3.
Is 160/100 blood pressure safe?
In the past, many clinicians felt that 160/100 was the upper limit of “safe” to treat, but that rule does not apply universally. I think it is entirely safe to treat some people when their blood pressure is higher than the “norm.”. It just depends on the patient’s age and history.
Can you have high blood pressure on medication?
The thing to remember is that some people have high blood pressure all of the time, even on medications. It would be wrong to deny treatment for such people, as we know that good preventive care is an integral part of good overall health.
What are the current dental management recommendations?
This review (1) compiled and evaluated dental management recommendations for select medical conditions; (2) summarized recommendations and their assigned levels of evidence; (3) identified areas of conflict, ambiguity, or both; and (4) identified issues that warrant future research, enhanced consensus statements, or both. Systematic literature searches were performed for guideline publications, systematic and narrative reviews, and opinion documents containing recommendations for (1) medication-related osteonecrosis of the jaw (MRONJ); (2) cardiovascular diseases (CVDs); (3) prosthetic joints (PJs); and (4) systemic steroid therapy (SST). The search yielded the following numbers of publications that met the inclusion criteria: MRONJ - 116; CVDs - 54; prosthetic joints - 39; and systemic steroids - 12. Very few of the compiled recommendations were assigned or linked to levels of evidence by their authors. Key conclusions include the following: MRONJ-expert recommendations trend toward proceeding with dental treatment with little to no modification in osteoporotic patients on bisphosphonates; CVDs-current recommendations are primarily directed to general surgery and applied to dentistry; PJs-routine antibiotic prophylaxis is not indicated for dental treatment; and SST-steroid supplementation is not indicated for most patients undergoing dental procedures under local anesthesia. Copyright © 2015 Elsevier Inc. All rights reserved.
How do systemic diseases affect dental care?
Systemic diseases are more common in older adults than in younger people, even among those who are functionally independent. Dentists should understand how these diseases can affect the dental care of their aging patients. The authors review some of the management issues associated with selected systemic diseases common in older adults who are functionally independent. To provide good oral health care, dental professionals must understand the special needs of older people and their ability to undergo and respond to care; they should work closely with the rest of the health care team; and they should be prepared to manage emergencies. Many older people have a variety of systemic diseases that have an impact on their oral health care. The dentist may need to consult with the patient's physician to develop an appropriate treatment plan.
What are the diseases that affect the oral cavity?
Types of disorders include cardiovascular disease, gastrointestinal disease, endocrinopathies, hematologic disease, cancer, obesity, osteoporosis, and neurologic disease. Oral lesions caused by treatment of systemic diseases can also be clinically significant, including those caused by cancer therapies and as well as medications that result in salivary compromise. This chapter will address the impact of key selected systemic diseases and/or systemic treatment on oral tissues. While the majority of such adverse effects on the oral cavity involve the oral mucosa, selected disorders can affect the dentition, periodontium, and/or salivary gland structures as well.
How many elderly people are there in Brazil?
According to the 2000 Brazilian Census, elderly people are over 14 million habitants. In consonance with what occurs worldwide, the Brazilian population is growing older and the elderly are expected to be over 33 million by the year of 2025. Although geriatric dentistry has already been recognized as a dental specialty, there is a lack of specialists in this branch of dentistry, which means that general dentists and other dental specialists will be dealing more and more with these patients. Aged individuals are commonly affected by a number of systemic diseases that have an impact on their oral health, such as cardiovascular and cerebrovascular diseases, diabetes mellitus, oral cancer, osteoporosis, Alzheimer's and Parkinson's diseases. Dental professionals must be prepared to treat properly these special patients. Therefore, the aim of this review article is to instruct dentist about these highly prevalent diseases affecting the elderly, as well as discuss their oral manifestations and dental implications, in order to propose a safe and adequate oral health care for these patients. Here we will shortly describe the diseases' etiology, main signs/symptoms and medical treatment and will discuss about how to proceed with dental treatment in patients suffering from these pathological conditions.
Is local anesthetic used in dentistry?
Objective: The use of local anesthetics associated to vasoconstrict or agents in dentistry is thoroughly justified and is widely extended, but we cannot ignore the fact that anesthetic infiltration poses risk of complications throughout the dental treatment period. The objective of the present review is to document the reported effects the use of the local anesthetics most widely employed in dentistry, with or without association to vasoconstrictor agents may have in patients with any sort of cardiopathy. Study design: We have searched for randomized clinical trials on the assessment of the cardiovascular effects of local anesthetics used in dentistry, without limits as regards age or sex, conducted in patients with any type of cardiopathy which were published during the last decade and were index-linked in Cochrane, Embase and Medline. Results: We have found six randomized clinical trials index-linked in Medline and Cochrane in the past ten years. These trials compare different types of anesthetics: lidocaine 2%, mepivacaine 2%, prilocaine 2% , associated or not to different vasoconstrictor concentrations such as adrenaline or felypressin. The cardiopathies affecting the patients included in the different trials range from hypertension, ischemic heart disease, arrythmias, chronic coronary disease to heart transplantation. Conclusions: The use of anesthetics associated to vasoconstrictor agents is justified in the case of patients with cardiopathies (once we get over the period in which any type of dental manipulation is contraindicated) and in controlled hypertensive patients. In any case, we must be very careful with the choice and execution of the anesthetic technique, being it possible to use a dose between 1.8 and 3.6 ml, on a general basis. Further studies are necessary to establish the effects of these drugs on severe hypertensive patients or in patients with other more advanced cardiopathies. Key words:Vasoconstrictor agents, epinephrine/adverse effects, local anesthetics, dental restoration, oral surgery, cardiovascular diseases, coronary arteriosclerosis, heart disease, hypertension, arrhythmias, coronariopathy.
Do orthodontists have to be medically compromised?
Orthodontists are confronted with an increasing number of medically compromised patients who require proper alignment for esthetics and oral rehabilitation. The present review is regarding the current knowledge of the most common systemic and local diseases on the outcome of orthodontic treatment, Fortunately in orthodontics complications are infrequent and are of minor consequence, nevertheless the practitioner should understand and have a basic knowledge and understanding of the disease and its impact on the oral cavity as it is essential to recognize oral signs and symptoms of undiagnosed medical problems too.
Is dental hypertension a harbinger of heart disease?
Hypertension is a common malady and a harbinger of such diseases as heart attack and stroke. Because millions of Americans are not aware they are hypertensive or it is not adequately controlled, dentists can contribute significantly to national health by screening their patients. Dentists must also be cognizant of the implications high blood pressure has for dental practice. Specific treatment recommendations include limiting dental care in patients with severe hypertension, reducing stress, and periodically monitoring blood pressure.
How can dental practitioners help with hypertension?
Dental practitioners can often be on the frontlines of prevention of hypertension by evaluating preoperative blood pressure readings, performing risk assessments, and knowing when to consider medical consultation of a hypertensive patient in a dental setting.
What are the names of the doctors who treat hypertension?
Janet H Southerland, 1 Danielle G Gill, 1 Pandu R Gangula, 2–4 Leslie R Halpern, 1 Cesar Y Cardona, 5 Charles P Mouton 6#N#1 Department of Oral and Maxillofacial Surgery, 2 Department of Oral Biology and Research, 3 Department of Physiology, 4 Center for Women's Health Research, 5 Department of Internal Medicine, 6 Department of Family and Community Medicine, Meharry Medical College, Nashville, TN, USA#N#Abstract: Hypertension is a chronic illness affecting more than a billion people worldwide. The high prevalence of the disease among the American population is concerning and must be considered when treating dental patients. Its lack of symptoms until more serious problems occur makes the disease deadly. Dental practitioners can often be on the frontlines of prevention of hypertension by evaluating preoperative blood pressure readings, performing risk assessments, and knowing when to consider medical consultation of a hypertensive patient in a dental setting. In addition, routine follow-up appointments and patients seen on an emergent basis, who may otherwise not be seen routinely, allow the oral health provider an opportunity to diagnose and refer for any unknown disease. It is imperative to understand the risk factors that may predispose patients to hypertension and to be able to educate them about their condition. Most importantly, the oral health care provider is in a pivotal position to play an active role in the management of patients presenting with a history of hypertension because many antihypertensive agents interact with pharmacologic agents used in the dental practice. The purpose of this review is to provide strategies for managing and preventing complications when treating the patient with hypertension who presents to the dental office.#N#Keywords: high blood pressure, dental, guidelines, inflammation, metabolic disease, blood pressure medicines
How do diuretics affect blood pressure?
By altering the way the kidney controls sodium, diuretics promote the production of urine by increasing the excretion of sodium and water from the bodies, decreasing blood volume, and therefore, decreasing blood pressure. 8 This regulation of sodium and water occurs at various segments of the renal tubular system. 8 Diuretics used in the management of hypertension include loop, thiazides, and potassium-sparing diuretics. Examples of commonly used diuretics include thiazide-type diuretics such as chlorthalidone, hydrochlorothiazide, and indapamide. The other class of diuretics includes the loop diuretics (furosemide, torsemide, bumetanide, and ethacrynic acid) and potassium-sparing diuretics (spironolactone, amiloride, triamterene, and eplerenone). 8 Side effects associated with this class of medications include hypokalemia, hyperlipidemia, constipation, hyperglycemia, muscle cramps, headache, increased perspiration, volume depletion that may lead to extreme thirst and dry mouth, and orthostatic hypotension. 23 Ototoxicity, most likely associated with ethacrynic acid use, is also an associated adverse effect. 8 Ototoxicity occurs most frequently in settings of rapid intravenous administration and is least likely to occur oral administration; it can manifest as a constellation of symptoms that include tinnitus, hearing impairment, deafness, vertigo, and a sense of fullness behind the ears. These are symptoms that patients may relay to their dental practitioner. 24 Adverse drug–drug interactions with diuretics are commonly seen with nonsteroidal anti-inflammatory drugs (NSAIDs) (resulting in a decreased antihypertensive effect), concomitant barbiturate use (resulting in orthostatic hypertension), and elevated plasma levels of fluconazole and erythromycin when used simultaneously. 23
What is the prevalence of hypertension in African Americans?
Prevalence of hypertension among African Americans is ranked the highest in the world, 9 representing 41.4% of hypertensive patients. 1 This number is significantly higher than in the Caucasian or Mexican American adult populations. 46 Compared with Caucasians, African Americans develop hypertension earlier in life and their average blood pressures are much higher. 1 As a result, African Americans have a 1.3-times greater rate of nonfatal stroke, 1.8-times greater rate of fatal stroke, 1.5-times greater rate of death attributable to hemodialysis, and 4.2-times greater rate of end-stage kidney disease. 1 African Americans are also less likely to be at goal blood pressure while being prescribed medication. 46 Whether the differences lie in access to care, poor diagnoses, poor treatment/medication noncompliance, or socioeconomic status, it is the duty of the primary health care provider, including the dentist, to aid in the prevention and education of hypertension.
Why is oral health important?
Most importantly, the oral health care provider is in a pivotal position to play an active role in the management of patients presenting with a history of hypertension because many antihypertensive agents interact with pharmacologic agents used in the dental practice.
How many people die from hypertension?
1 – 3 By 2025, the number of patients diagnosed with hypertension is expected to be 1.56 billion. 3 Hypertension is responsible for >7 million deaths annually 4 and is one of the leading risk factors for cardiovascular disease mortality. 5 The disease is defined as systolic blood pressure (SBP) of 140 mmHg or diastolic blood pressure (DBP) ≥90 mmHg, or any persons being currently prescribed antihypertensive medicine for the purpose of managing hypertension. 1, 2, 6 In addition, hypertension is defined as blood pressure readings elevated on at least two occasions with or without provocation. 1
What are the two main categories of hypertension?
Hypertension is divided into two main categories: essential/primary hypertension and secondary hypertension. 7, 8 Lack of identifiable causative factors for elevated blood pressure is known as essential or primary hypertension, making up ~90%–95% of all hypertensive cases.
What is the first line of treatment for stage 1 hypertension?
Thus, the JNC7 recommends diuretics as first-line therapy for management of stage 1 Hypertension, while a combination of two drugs are recommended as initial therapy of stage 2 Hypertension, one of which should be a diuretic. SIGNIFICANCE FOR THE DENTIST.
What happens if blood pressure rises?
PREVENTION. If the rise in blood pressure can be prevented, the concurrent risk of congestive heart failure and stroke would be decreased. Fortunately, the important causal factors associated with hypertension have been identified and are readily preventable.
What tests are recommended for JNC7?
Baseline tests such as an electrocardiogram, urinalysis, blood glucose, complete blood count, electrolytes, creatinine, as well as a lipid profile are recommended by JNC7 to assess etiology, progression, effects, and other existing co-morbidities of this condition.
How long should you sit on the floor before a heart rate test?
The preferred method is auscultation, with the patient seated quietly for at least 5 minutes with feet on the floor and arm at the level of the heart, rather than lying down on a table. To help avoid artificially high readings, caffeine, exercise and smoking should be avoided at least 30 minutes prior to measuring.
Is thiazide a harmacologic treatment?
harmacologic treatment of hypertension has been shown to reduce the complications of this condition using several classes of medication. Thiazide diuretics have been the basis of therapy in most clinical trials and have been shown to be most effective especially in preventing the cardiovascular complications.
Is hypertension a major health concern?
Hypertension-associated morbidity and mortality is a major heath concern, however with appropriate treatment, hypertension can be managed and the associated sequelae, reduced. The key to controlling this disease depends on proper and timely, prevention, detection, evaluation and treatment.
Why is it important to manage dental emergencies?
The most important aspect of nearly all medical emergencies in the dental office is to prevent, or correct, insufficient oxygenation of the brain and heart. Therefore, the management of all medical emergencies should include ensuring that oxygenated blood is being delivered to these critical organs.
What is the extent of treatment by the dentist?
The extent of treatment by the dentist requires preparation, prevention and then management, as necessary. Prevention is accomplished by conducting a thorough medical history with appropriate alterations to dental treatment as required.
How much salbutamol should I take for anaphylaxis?
Initial doses for the management of anaphylaxis are 0.3 to 0.5 mg intramuscularly or 0.1 mg intravenously. These doses should be repeated as necessary until resolution of the event. Similar doses should be considered in asthmatic bronchospasm which is unresponsive to a beta-2 agonist, such as albuterol or salbutamol.
What is the best medication for anaphylaxis?
A positive pressure device may be used in adults, provided that the flow rate does not exceed 35 liters per minute. 2. Epinephrine . Epinephrine is the drug of choice for the emergency treatment of anaphylaxis and asthma which does not respond to its drug of first choice, albuterol or salbutamol.
What are the other emergencies that dentists report?
In addition to syncope, other emergencies reported to have occurred include allergic reactions, angina pectoris/myocardial infarction, cardiac arrest, postural hypotension, seizures, bronchospasm and diabetic emergencies. The extent of treatment by the dentist requires preparation, prevention and then management, as necessary.
How long does epinephrine take to work?
As a drug, epinephrine has a very rapid onset and short duration of action, usually 5 to 10 minutes when given intravenously. For emergency purposes, epinephrine is available in two formulations. It is prepared as 1 : 1,000, which equals 1 mg per ml,for intramuscular, including intralingual, injections.
What is the most common emergency seen by dentists?
In the United States and Canada, studies have also shown that syncope is the most common medical emergency seen by dentists.2,3Syncope represented approximately 50% of all emergencies reported in one particular study, with the next most common event, mild allergy, represented only 8% of all emergencies.