Hypertension (High Blood Pressure)
Measuring for Hypertension is an important screening vital sign at dental visits.
Hypertension
Chronic hypertension is blood pressure that remains consistently higher than normal. Diagnosis of hypertension is generally based on an average of two or more elevated measurement readings obtained on two or more occasions. Although the exact cause of hypertension may be unclear, factors that contribute to its development include obesity, smoking, lack of physical activity, diet (e.g., excess sodium or alcohol intake), age, familial history/genetics, pain, medications (e.g., stimulants, decongestants, immunosuppressants, corticosteroids, oral contraceptives) and certain diseases (e.g., chronic kidney disease, thyroid or adrenal disorders, sleep apnea).
Implications of Hypertension in Dental Care
One approach to obtaining a medical history is to evaluate vital signs, including heart rate (pulse) and blood pressure, at every dental visit. 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. When interviewed for a medication history, people may not know which of their medications are for hypertension; also, patients whose hypertension is well-controlled may not consider themselves as having high blood pressure, when asked.
Oral Effects of Hypertension Medications
Most classes of antihypertensive mediations can cause dry mouth. Treatment of medication-related adverse oral effects may be as simple as addressing the symptom (e.g., encouraging frequent sips of water in people with medication-related dry mouth) or may require working with the person’s medical doctor to change treatment. For example, gingival hyperplasia induced by calcium-channel blocker therapy may be treated surgically to temporarily relieve overgrowth, pain, and bleeding, but recurrence is likely unless the causative medication is discontinued.