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High blood pressure and dental complications

High blood pressure, in other word, hypertension, is the silent killer! Would you agree with me? Its silent nature comes from a lack of symptoms until there is deadly damage done to the body.

From 1995, 24% of Americans were diagnosed with hypertention, and it went up to 46% in 2017, not counting the good part of population that is undiagnosed. It can go up to 50-70% if we don't understand how it happens and its serious affect on our dental and general health. The list of its complications goes on and on and not limited to heart diseases (ischemic necrosis, heart failure, atrial fibrillation,...), pulmonary embolism (coughing with blood, shortness of breath, chest pain), swollen extremities, nerve damage (neuropathy, retinopathy), cognitive impairment and premature death. Its rate goes up in children and adolescents in the recent years. That is a sad toll that strikes younger and younger population that we need to be aware of. The good news is, it is totally preventable. We will talk about the preventive mesures at the end. However, the main purpose of this post, is to give you the information about how hypertension and its medication can affect negatively your dental treatment.

- Uncontrolled bleeding during surgical procedure ( gum surgery, implant placement, sinus lift, wisdom teeth extraction,...)

- Hypertension crisis with anesthesia (with epinephrine)

- Drugs interaction (your hypertension medication can interact with medications that your dentist prescribes you) that can increase the side effects or reduce/lenghten the drug efficiency

- Drymouth that can lead to increased caries risk, bad breath, mouth burning sensation

- Gum enlargement

- Gum inflammation, gum bleeding, infection

- Lichenoid reaction (similiar to skin rash but in the mouth)

The point is, all of this can be avoided, please always bring with you the list of medications that you are taking to your dentist/doctor so he/she will prescribe medications if needed for you and your safety with the least drug interactions/ side effects.

If you have hypertension, your dentist will measure your blood pressure before any intervention. He/she may dismiss you if your pressure is more than 180mmHg systolic. Be prepared and don't be surprised or feel angry or offended. At the end of the day, we want the best for our patients.

What can you do to make the appointment safe when you have hypertension?

- Ask for early appointment (morning preferrable)

- Take your medications early in the morning when you have breakfast

- No coffee, no tea the day of appointment (caffeine elevates your blood pressure significantly) (Folks, if you can, give your self a good caffeine-free break)

- No strenuous physical activities (brisk walk, yoga, tai-chi or any mild to moderate exercise is totally fine)

- No alcohol/ tobacco use 1-2 days around appointment time

- Limit salty food the day before and the morning of the appointment

Any small thing you do for yourself counts. Make it small and make it last.

Do you realize that the disease can not be treated with medication alone? If you want to cure it, cure it from the root.

Here is my reccommendations: (I hope that helps, please also consult with your primary care physician)

- Change your diet (more fruit, more vegetables, less meat and fatty oily fried food)

- Reduce salty food, energy drinks, coffee and tea (green tea is ok with moderation)

- Reduce alcohol intake, tobacco

- Stress management

- Increase level of vitamin D (if you are vitamin D deficient) by exposing to early sunlight and taking vit D supplements

- Mild to moderate physical exercises at first , brisk walking >30 minutes/day is really good

- Weight loss management

- AND Be happy

There are so many things that you can do, just remember, change is scary, but it is necessary. Commit to small changes everyday and maintain it. Don't go extreme. If you need more tips and want to talk more about this topic, please email me at, subject Hypertension. I would love to discuss and help you to maintain good habits and hear your feedback.

Can't wait for our next topic on Diabetes and Dental treatment.

All the best and good luck!

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