A few months ago a patient left me a voicemail. The message was an interesting one for a dental practice to receive. She said, “I wanted to call you and thank you. Your offices policy just saved my life.” When I called her back she explained her message. She had recently begun coming to our office after many years at a different practice. When she had her first preventive care appointment with one of our hygienists, they took her blood pressure at the start of the appointment. The patient told me that she didn’t really want to have it taken, just didn’t feel it was necessary. No dentist or hygienist had ever done that before. But after listening to the hygienist explain why, she agreed to do it. Her blood pressure was high. The hygienist took it a couple of times during the appointment to ensure accuracy and recommended that the patient contact her physician to check it. When she got to her PCP she was told it was dangerously high and she needed treatment immediately to start getting it under control. They explained to her that left untreated she could have had a stroke soon. So she wanted to thank us for finding the problem and sending her to the physician.
But why were we taking it in the first place?
We are being asked this question frequently these days. Some people feel that we are invading their health privacy by doing this. Sometimes they just don’t understand why their blood pressure would matter for what to them is a routine appointment. There are others who already know their blood pressure is high and just don’t want to have that conversation with another health care provider.
So, why do we do it?
As a practice we decided that we would do better about honoring the request of the American Heart Association and the American Dental Association to screen blood pressure at all appointments. It was in the mid-seventies that these organizations first began recommending that the dental profession do these screenings. In the past we offered it, but we are now requiring it.
Why?
Most people see their dentist more often than they see their primary care physician (PCP). More than half of the adult population sees the dentist at least once per year. Most only see their PCP every couple of years. High blood pressure often has no symptoms (therefore it is often called “the silent killer”). So having us check it will give you an opportunity to monitor an important piece of your health information.
It is important to know your blood pressure to determine the appropriate anesthetic levels needed. Your appointment may involve the use of local or topical anesthesia. Ingredients in some of these may put a patient with high blood pressure at risk for a serious medical event.
The anxiety sometimes associated with a visit to the doctor or dentist can cause your blood pressure to rise. This is a natural response, but in a person who already has high blood pressure it could raise it to the point where it may provoke a medical emergency such as stroke or heart attack. Establishing a blood pressure baseline prior to treatment creates a safeguard for your health.
If there is a medical emergency, the very first question the emergency responders will ask us is what your blood pressure was.
There are many connections between your oral health and your cardiovascular health. Many serious medical conditions can first be detected in your mouth. As one of your health care providers we care about more than just your oral health. Your mouth is truly connected to the rest of your body. We want to ensure that you are healthy overall and will take every precaution to help you care for yourself appropriately. There is no such thing as “Just a cleaning” or “Only a filling”!
We are always here to answer your questions, please understand that we will always do what is in the best interest of our patients. Help us do that.
By Eleanor Hoyle, R.D.H.