Risks Of Dental Treatment When You Have High Blood Pressure

Dentist Blog

Uncontrolled high blood pressure, known as hypertension, can increase your risk of cardiovascular and cerebrovascular disease—conditions that can lead to heart attack or stroke. High blood pressure can also compromise your dental care, putting you at increased risk for an adverse cardiac-related reaction during treatment. Therefore, your dental professional needs to know if there is a problem with your blood pressure before treating you.

Risk Factors

If you have high blood pressure, it's important for your dentist to know, especially if your blood pressure is uncontrolled and you need a dental procedure. Unless you require emergency dental treatment, you may have to delay the procedure if your blood pressure is too high or you are at risk for factors that can cause your blood pressure to rise.

Adverse Reaction to Local Anesthetics

If a dental procedure requires the use of a local anesthesia, your dentist needs to be aware that you have high blood pressure. Dentists are trained in treating individuals with high blood pressure and therefore will consider the severity of your high blood pressure and the types of blood pressure medications you are taking before deciding on which anesthetic to use. He or she will also take into account other health issues you may have.

Local anesthetics with vasoconstrictors can cause elevated heart rate and a rise in blood pressure. Therefore, your dentist may decide against the use of vasoconstrictors or reduce the dose if you have high blood pressure or have had a recent heart attack or stroke. What is considered a normal dosage for most people can be an overdose for individuals with chronic health problems.

Gag Reflex

Your dentist also needs to be careful not to stimulate your gag reflex if you have a history of hypertension. The vagus nerve—a long cranial nerve that extends from the base of the brain down the throat and and into the chest and pelvic regions—helps regulate heart rate and blood pressure. Stimulation of the nerve can cause your blood pressure to drop and your heart rate to slow. Excessive or sudden stimulation of the nerve may even cause the loss of consciousness in some people.

Another problem is that some ACE inhibitors doctors prescribe to treat high blood pressure can cause coughing, sometimes so severe that it causes gagging and vomiting, making dental visits more challenging for you and your dentist both. If that's the case, ask your primary care physician to prescribe a different medication.

A class of medications known as angiotensin II receptor blockers (ARB) are less likely than ACE inhibitors to cause a cough as a side effect. But like ACE inhibitors, the medicine lowers blood pressure, reducing the risk of heart complications associated with dental procedures.


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