Oral health care considerations for patients with high blood pressure and/or hypertension
- Changes in class of antihypertensive medications, as well as change in dosages suggests a more severe disease.
- Patients exhibiting signs and symptoms of high blood pressure are at higher risk for an adverse event.
- Patient’s measured blood pressure in combination with target organ diseases will determine modifications for routine dental care. (See the table below.)
- A systolic blood pressure >150 mm Hg may predispose a patient with a recent (within 120 days) non-cardio-embolic ischemic stroke to a recurrent stroke.
- Individuals who have not met recommended blood pressure goals should be referred to their physician.
Oral care consideration
|Patients with controlled hypertension.||No modifications are necessary.|
|Asymptomatic patients with BP <149/99 mm Hg and no history of target organ damage.||No modifications are necessary.|
|Asymptomatic patients with BP 150-179/100-109 mm Hg and no history of target organ damage.||Assess on an individual basis and with regard to the type and duration of the dental procedure. Be aware of an increased risk for a recurrent ischemic stroke.|
|Patients with BP >180/110 mm Hg and no target organ damage.||Avoid elective dental care. Treat emergencies with analgesics and antibiotics as needed.|
|Patients with target organ damage, other signs and symptoms of elevated BP, or poorly controlled diabetes mellitus (DM).||Emergency care with analgesics and antibiotics as needed when BP is uncontrolled (>140/90 mm Hg or >130/80 mm Hg for patients with DM).|
|Hypertensive urgency||Avoid elective dental care. Treat emergencies with analgesics and antibiotics as needed.|
|Hypertensive emergency||Avoid elective dental care. Treat emergencies with analgesics and antibiotics as needed.|