Knowing the blood pressure before dental treatments
Knowing the blood pressure before dental treatments
What is blood pressure?
When heart contracts blood exerts heart and goes against arterial walls traveling in all parts of the body. This force or pressure created by the contractions of the heart is called blood pressure. A normal heart beats or contractions create a 120 mm/Hg systolic pressure and 80 mm/Hg diastolic pressure.
What is a systolic or diastolic pressure?
Systolic blood pressure is considered the maximum pressure against the arterial walls during cardiac ventricular contraction. This is the number we see on the sphygmomanometer at the first heart beat we hear while performing a blood pressure examination.
Diastolic blood pressure is the number we see on sphygmomanometer on the last beat we hear. Diastolic pressure measures the minimum blood pressure occurring against the arterial walls due to ventricular relaxes. These two numbers identify the blood pressures parameters. As i mentioned earlier the normal range blood pressure readings for an adult are 120/80.
Why do we need to know blood pressure?
By knowing the blood pressure readings we are in able to identify heart activity, functionality, risk of diseases that might occur in the future and any possible emergency that might occur in a dental operatory. Blood pressure readings are a major factor in discovering early cardiovascular mortality that’s why dentists and dental hygienists have the obligation to make accurate readings for new patients that come in the office.
Dental considerations
High blood pressure or hypertension is the number one leading death disease in North America, that’s why taking the right precautions (assessing Vital signs) in preventing dental emergencies are strongly recommended to be done periodically. The patient should be considered an hypertensive patient if the systolic pressure is more then 140 and diastolic is more 90.
When a dental practitioner assesses the blood pressure it is necessary to document the findings, write the date, arm side taken and initials the chart every time the patient comes in the office for a recall. ASA classifications provide dentists and dental hygienists with guidance towards the management of cardiac clients.
Factors influencing blood pressure
AGE - As people age blood pressure rises because the reduction of the elasticity in arteries, causing an increase of the blood pressure. As the blood pressure remains high for a long period of time the client is classified as hypertensive therefore concerns from the dental team need to be addressed appropriately by referring the patient to a physician, and making sure that the patients blood pressure is taken at any recall appointment to avoid any complications during the dental treatment.
RACE - Prevalence of hypertension is lower in the black or Hispanic populations.
WEIGHT - Obese and overweight people tempt to have an elevated blood pressure compare to people the same age but lower in weight. Cholesterol is one of the factors.
STRESS - Cardiac output is controlled by the sympathetic nervous system. When the client is under the influence of stress hormonal levels of adrenaline in blood stream increase and stimulate the sympathetic nervous system, increasing the cardiac output. This makes the heart pump harder and as a outcome increasing the blood pressure.
GENDER - Since the hormonal levels are responsible for controlling the blood stream even the blood pressure will change if we have to different people with a different hormonal production needs. Male differ from female in this point because it’s a known fact that male have a higher hormonal secretion then female. This hormonal variation makes male having a normal higher blood pressure, and female having a normal lower pressure compare to male.
PAIN - Pain can increase B.P. but shock will lower it, sometimes catastrophically.
MEDICATIONS - Medications can increase or decrease the blood pressure. Its very important to review medical history and update it as necessary at each appointment to determine the effect in blood pressure.
TABACCO CAFFEINE ALCOHOL - All users are subject of having a high blood pressure.
DIURINAL VARIATION – Renal system controls metabolism. A dysphunction of this system might cause uncontrolled blood pressure. Also its important for the practitioner to know that the metabolic rates differ during the day causing increase or decrease in blood pressure. For example BP in the morning is lower compare to early evening.
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