Tuesday, October 22, 2013

Dental guidelines for high blood pressure

Hypertension affects nearly 50 million people in the United States and underlies most cardiovascular disease. The American Dental Association believes that the detection of heart disease be a concern for all health care providers, including dentists. The ADA recommends that dental offices take blood pressure on all new patients and annually on all recalls. 

Blood Pressure and Heart Disease
Untreated high blood pressure can cause damage to the heart and coronary arteries, including heart attack, heart disease, congestive heart failure, aortic dissection and atherosclerosis. The American Journal of Cardiology recommends patients with high blood pressure (a risk factor for heart disease) and moderate to severe periodontal disease consider a medical evaluation if they have not had one in the past 12 months.

Blood Pressure and Diabetes
High blood pressure is an important risk factor for the development and worsening of many complications of diabetes. The U.S. Preventive Services Task Force states that asymptomatic adult patients with sustained high blood pressure, greater than 135/80 should be tested for diabetes, even in the absence of symptoms. The American Academy of Periodontology recommends patients with high blood pressure (a risk factor for diabetes) and periodontal disease be referred to a physician.

Blood Pressure and Sleep Disorders
High blood pressure can be an indicator of obstructive sleep apnea. Assessing blood pressure and asking patients a few simple questions can uncover a potential sleep disorder that could be treated with an oral appliance in the dental office. Approximately 18 million Americans have a potentially  life-threatening sleep disorder. 

Blockage of  both carotid arteries visible on a dental panoramic radiograph:


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