WHAT'S YOUR NUMBER?

As World Hypertension Day quickly approaches, we are forced to recognize the ill-effects of High Blood Pressure (HBP) & the importance of screening tools we have at our disposal.  HBP effects every aspect of the body…from your head to your toes…and can be fatal if left uncontrolled. 

In the dental industry, we are fortunate to see our patients at least twice per year – more than most see their primary care physician.  This allows us to regularly screen for any Blood Pressure (BP) issues and help prevent any other health issues from occurring.  Amazingly, many health problems first show symptoms in the mouth, but HBP is not one of them.  For this reason, a BP screening is provided. 

Some people think a Blood Pressure Screening is silly & doesn’t have a place in the dental office.  But here’s a true story that will hopefully change your mind—and yes, it happened recently in your town. 

A man (we’ll call him Joe) arrived at a dental office for treatment.  It was standard office protocol that BP was taken prior to any dental procedure & Joe thought it was silly to have his BP taken.  Joe’s BP was high & in an unsafe range, so the dentist advised Joe be seen by his Primary Care Physician (PCP) for a BP evaluation.  Joe was disgruntled & walked out of the dental office without treatment and decided to just go to another dental office where he could have treatment done without having to worry about someone taking his “silly” BP.  It was later found out that Joe appointed with another dental office that did not screen for BP prior to dental procedures and, unfortunately, had a heart attack in the dental chair.  Yes, a Heart Attack!

Could this event have been prevented?  Yes.  In order to understand why, we first need to understand what blood pressure and the numbers associated with it actually mean.

A Blood Pressure Screening measures the amount of pressure and stress put on the artery walls of the heart.  The higher the pressure, the more stress and work the heart has to endure, leading to a shortened life span.  (According to the American Heart Association (AHA), even a moderate increase in pressure leads to a shortened life span.)  The amount of pressure on the heart is associated with numbers—systolic and diastolic.  Simply put, the top number (systolic) tells us how hard your heart is working when it is contracting vs the bottom number (diastolic) which tells us how hard your heart is working when it is resting. 

A healthy blood pressure is considered to be 120/80 or less.  A person is considered pre-hypertensive (at risk for HBP) when the top number (systolic) is above 121-139 or the lower number (diastolic) is 80-89, and anything over 140-179 (systolic) or 100-109 (diastolic) is considered hypertensive, meaning the person has HBP and the heart is having to work harder than it should.  [If you are diabetic and your top number (systolic) is 130, then you are considered having HBP.] Any numbers greater than 180 (systolic) or 110 (diastolic) qualifies as a hypertensive crisis, according to the AHA, meaning you have severe HBP resulting in organ damage. 

So how does all of this affect your dental appointment?  Any dental service provided, whether it be a cleaning or a crown, effects your blood pressure.  If you walk into a dental office for treatment and your BP is already in the “high” range before we do anything, it will only increase once treatment begins.  Anesthesia, anticipation, pain, stress, etc all increase BP further.  And remember, according to the AHA, even a moderate increase in pressure leads to a shortened life span.

The heart is like any other muscle in the body that can become overworked & fatigued.  The difference is that the heart is your lifeline and an overworked or fatigued heart results in life-altering or fatal complications.     

So the next time your dental provider wants to screen for HBP, don’t think it’s silly & walk out of the office disgruntled like Joe—be thankful that someone is looking after your safety and health.  The ability to catch things at an early stage can prevent a lifetime of complications, or something even more fatal.