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Doble A, Bescos R, Witton R, Shivji S, Brookes Z. Uncontrolled hypertension at the dentist: a case report of integrated healthcare. Br Dent J 2023; 235:866-868. [PMID: 38066140 DOI: 10.1038/s41415-023-6546-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/10/2023] [Accepted: 08/22/2023] [Indexed: 12/18/2023]
Abstract
Hypertension is a risk factor for major cardiovascular events and it is usually detected and managed by general medical practitioners (GPs) in primary care. However, it is estimated that 4.8 million adults are living with untreated high blood pressure (BP) in the UK. Health authorities are encouraging more collaborative work across health professions to find and refer individuals with undiagnosed hypertension. In this case, in 2022, a 65-year-old man with a previous history of hypertension, taking antihypertensive medication, attended a BP clinic at the University of Plymouth, Peninsula Dental School as part of a hypertension case finding pilot. His systolic and diastolic BP were 150 and 85 mmHg, respectively, and as per the trial protocol, a referral letter was sent to his GP for suspected further assessment and investigation. Then, an onward referral was made to secondary care and the participant was subsequently hospitalised for 13 days for treatment of heart failure and suspected acute coronary syndrome. This case report highlights that BP readings taken in a primary care dental setting can be very useful and recommends better integration of dental services into primary care to reduce the risk of major cardiovascular events.
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Affiliation(s)
- Amazon Doble
- Peninsula Dental School, University of Plymouth, United Kingdom.
| | - Raul Bescos
- School of Health Professions, University of Plymouth, Plymouth, PL4 8AA, United Kingdom
| | - Robert Witton
- Peninsula Dental School, University of Plymouth, United Kingdom
| | - Shabir Shivji
- Office of the Chief Dental Officer, London, SE1 6LH, United Kingdom
| | - Zoë Brookes
- Peninsula Dental School, University of Plymouth, United Kingdom
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2
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Doble A, Bescos R, Witton R, Shivji S, Ayres R, Brookes Z. A Case-Finding Protocol for High Cardiovascular Risk in a Primary Care Dental School-Model with Integrated Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4959. [PMID: 36981868 PMCID: PMC10049228 DOI: 10.3390/ijerph20064959] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND National Health Service (NHS) strategies in the United Kingdom (UK) have highlighted the need to maximise case-finding opportunities by improving coverage in non-traditional settings with the aim of reducing delayed diagnosis of non-communicable diseases. Primary care dental settings may also help to identify patients. METHODS Case-finding appointments took place in a primary care dental school. Measurements of blood pressure, body mass index (BMI), cholesterol, glucose and QRisk were taken along with a social/medical history. Participants with high cardiometabolic risk were referred to their primary care medical general practitioner (GP) and/or to local community health self-referral services, and followed up afterwards to record diagnosis outcome. RESULTS A total of 182 patients agreed to participate in the study over a 14-month period. Of these, 123 (67.5%) attended their appointment and two participants were excluded for age. High blood pressure (hypertension) was detected in 33 participants, 22 of whom had not been previous diagnosed, and 11 of whom had uncontrolled hypertension. Of the hypertensive individuals with no previous history, four were confirmed by their GP. Regarding cholesterol, 16 participants were referred to their GP for hypercholesterolaemia: 15 for untreated hypercholesterolaemia and one for uncontrolled hypercholesterolaemia. CONCLUSIONS Case-finding for hypertension and identifying cardiovascular risk factors has high acceptability in a primary dental care setting and supported by confirmational diagnoses by the GP.
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Affiliation(s)
- Amazon Doble
- Faculty of Health, University of Plymouth, Plymouth PL4 8AA, UK
| | - Raul Bescos
- School of Health Professions, University of Plymouth, Plymouth PL4 8AA, UK
| | - Robert Witton
- Faculty of Health, University of Plymouth, Plymouth PL4 8AA, UK
| | - Shabir Shivji
- Office of the Chief Dental Officer, London SE1 6LH, UK
| | - Richard Ayres
- Faculty of Health, University of Plymouth, Plymouth PL4 8AA, UK
| | - Zoë Brookes
- Faculty of Health, University of Plymouth, Plymouth PL4 8AA, UK
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Diendéré J, Kaboré J, Bosu WK, Somé JW, Garanet F, Ouédraogo PV, Savadogo AA, Millogo A, Zeba AN. A comparison of unhealthy lifestyle practices among adults with hypertension aware and unaware of their hypertensive status: results from the 2013 WHO STEPS survey in Burkina Faso. BMC Public Health 2022; 22:1601. [PMID: 35999516 PMCID: PMC9396908 DOI: 10.1186/s12889-022-14026-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 08/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We compared the prevalence of unhealthy lifestyle factors between the hypertensive adults who were aware and unaware of their hypertensive status and assessed the factors associated with being aware of one's hypertension among adults in Burkina Faso. METHODS We conducted a secondary analysis of data from the World Health Organization Stepwise approach to surveillance survey conducted in 2013 in Burkina Faso. Lifestyle factors analysed were fruits and vegetables (FV) consumption, tooth cleaning, alcohol and tobacco use, body mass index and physical activity. RESULTS Among 774 adults living with hypertension, 84.9% (95% CI: 82.2-87.3) were unaware of their hypertensive status. The frequencies of unhealthy lifestyle practices in those aware vs. unaware were respectively: 92.3% vs. 96.3%, p = 0.07 for not eating, at least, five FV servings daily; 63.2% vs. 70.5%, p = 0.12 for not cleaning the teeth at least twice a day; 35.9% vs. 42.3%, p = 0.19 for tobacco and/or alcohol use; 53.9% vs. 25.4%, p = 0.0001 for overweight/obesity and 17.1% vs, 10.3%, p = 0.04 for physical inactivity. In logistic regression analysis, older age, primary or higher education, being overweight/obese [adjusted odds ratio (aOR) = 3.2; p < 0.0001], intake of adequate FV servings daily (aOR = 2.9; p = 0.023) and non-use of alcohol and tobacco (aOR = 0.6; p = 0.028) were associated with being aware of one's hypertensive status. CONCLUSION Undiagnosed hypertension was very high among Burkinabè adults living with hypertension. Those aware of their hypertension diagnosis did not necessarily practise healthier lifestyles than those not previously aware of their hypertension. Current control programmes should aim to improve hypertension awareness and promote risk reduction behaviour.
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Affiliation(s)
- Jeoffray Diendéré
- Centre National de la Recherche Scientifique et Technologique (CNRST)/Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso.
| | - Jean Kaboré
- Centre National de la Recherche Scientifique et Technologique (CNRST)/Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
| | - William Kofi Bosu
- Department of Public Health and Research, West African Health Organisation (WAHO), Bobo-Dioulasso, Burkina Faso
| | - Jérome Winbetouréfâ Somé
- Centre National de la Recherche Scientifique et Technologique (CNRST)/Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso
| | - Franck Garanet
- Centre National de la Recherche Scientifique et Technologique (CNRST)/Institut de Recherche en Sciences de la Santé (IRSS) Unité de Kaya, Kaya, Burkina Faso
| | | | - Abdoul Aziz Savadogo
- Université Nazi Boni/Institut Supérieur des Sciences de la Santé (INSSA), Bobo-Dioulasso, Burkina Faso
| | - Athanase Millogo
- Université Joseph Ki-Zerbo/Centre Hospitalier Universitaire Sourô Sanou, Bobo-Dioulasso, Burkina Faso
| | - Augustin Nawidimbasba Zeba
- Centre National de la Recherche Scientifique et Technologique (CNRST)/Institut de Recherche en Sciences de la Santé (IRSS), Bobo-Dioulasso, Burkina Faso
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Carreira-Míguez M, Belinchón-deMiguel PP, Clemente-Suárez VJ. Behavioural, odontological and physical activity patterns of hypertense and control population. Physiol Behav 2022; 252:113841. [PMID: 35561809 DOI: 10.1016/j.physbeh.2022.113841] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/04/2022] [Accepted: 05/09/2022] [Indexed: 01/04/2023]
Abstract
Behavioural and multifactorial factors such as odontological and physical activity habits are controlling factors in hypertension. The aim of the present study was to analyze differences in behavioral, odontological and physical activity patterns of hypertense and control population. Fifty participants with hypertension (57.5±13.6 years) and 100 participants as control group with no hypertension disease (48.9±7.9 years) were interviewed via online questionnaire. Multifactorial items in oral behavioral, health habits and physical activity profile were analyzed by a compendium of questionnaires. Result showed how control group showed significantly lower age, weight, body mass index, TV hours per day, gastritis or heartburn, dental sensibility, and sick days last year, and significantly higher level of academic education, quality of sleep and daily toothbrushing than hypertension group. In conclusion our results showed that hypertense patients presented higher levels of overweight, poor sleep quality and sedentary behaviors than control participants. In addition, hypertense patients also presented poor odontological health, showing higher indices of gastritis, dental sensibility, and sick days per year. Both groups presented a low physical activity pattern. This information allows to better understand of a multifactorial disease, as well to the creation of protocols for intervention and prevention of this disease at the behavioral level and lifestyle.
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Affiliation(s)
- María Carreira-Míguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, Madrid 28670 , Spain.
| | | | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, Madrid 28670 , Spain; Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia.
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FARGHALY MAHASSENMOHAMED, SABAH AYMANABDELHAMID, KERAA KHALEDMOHAMED. Association between oral health-related quality of life and general health among dental patients: a cross-sectional study. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E67-E74. [PMID: 34322619 PMCID: PMC8283636 DOI: 10.15167/2421-4248/jpmh2021.62.1.1649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 10/13/2020] [Indexed: 11/16/2022]
Abstract
Globally, the prevalence of chronic diseases is increasing significantly, causing deterioration of oral and general health and therefore quality of life. The present study was designed to assess the relationship between oral health-related quality of life and general health of dental patients. The study is part of the University's plan to achieve the United Nations Sustainable Development Goals number 1, 3, 4 and 5. Dental school students' satisfaction with their early engagement in clinical activities and research work was also evaluated. A convenience sample of 600 subjects attending dental clinics aged ≥18 years of both sexes was included in the study. Second-year dental students conducted the study under the supervision of public health staff members over two successive academic years (2015-2016 and 2016-2017). Oral health-related quality of life was assessed using the Dental Impact on Daily Living (DIDL) questionnaire. Blood pressure, random blood glucose level, body mass index, and waist circumference were measured as indicators of general health. There were statistically significant inverse correlations between DIDL scores and both mean blood pressure (r = -0.215, p < 0.001) and mean blood glucose level (r = -0.272, p < 0.001). Non-significant inverse correlations were observed between DIDL scores and both body mass index (r = -0.062, p = 0.131) and waist circumference (r = -0.040, p = 0.340). Students' satisfaction scores with research activities were high, ranging from 75.9% to 78%. Dentists must raise patients' awareness about the importance of oral health and its impact on their quality of life and general health. Participation of dental students in dental research is encouraged even in their early academic years.
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Affiliation(s)
| | | | - KHALED MOHAMED KERAA
- Correspondence: Khaled Mohamed Keraa, Faculty of Oral & Dental Medicine, Misr International University, Cairo, Egypt - E-mail:
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Calcium channel blockers, angiotensin II receptor antagonists and alpha-blockers accentuate blood pressure reducing caused by dental local anesthesia. Clin Oral Investig 2021; 25:4879-4886. [PMID: 33506427 DOI: 10.1007/s00784-021-03795-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The primary aim of this study was to investigate the effect associated with patients' factor such as systemic disease on the blood pressure of patients in dental procedure. The secondary aim of this study was to investigate the effect associated with systemic disease and antihypertensive on the blood pressure changes with local anesthesia. METHODS The blood pressure was measured before and after local anesthesia injection for dental treatment. The effect associated with patients' factor such as systemic disease on the blood pressure and the effect on blood pressure changes of the type of antihypertensive drugs and the systemic disease were analyzed using a multivariate analysis of variance test. RESULTS We analyzed 1306 patients scheduled for the dental procedure. Age and some systemic diseases such as hypertension and angina pectoris affected blood pressure before local anesthesia. On the other hand, age and systemic diseases did not affect blood pressure changes. And, some antihypertensive affected systolic blood pressure changes. CONCLUSIONS The blood pressure change with local anesthesia was not associated with systemic diseases and age but was associated with antihypertensive agents. In particular, calcium channel blockers, angiotensin II receptor antagonists and alpha-blockers accentuate blood pressure reducing caused by local anesthesia. CLINICAL RELEVANCE The blood pressure change with local anesthesia was associated with antihypertensive agents. This study was registered with the University Hospital Medical Information Network Clinical Trials Registry (number UMIN000030695).
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FARGHALY M, BADRAN A, KERAA K. Assessment of oral hygiene trends among dental patients in relation to chronic medical conditions by dental students. A cross-sectional study. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E109-E118. [PMID: 31312740 PMCID: PMC6614563 DOI: 10.15167/2421-4248/jpmh2019.60.2.1098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 04/05/2019] [Indexed: 12/05/2022]
Abstract
INTRODUCTION There is a lack of information about knowledge, attitude and behavior regarding oral hygiene and dietary habits of adult patients attending dental clinical settings. Hypertension, diabetes, obesity and caries are increasing among different populations, resulting in the deterioration of the quality of life related to oral and general health. OBJECTIVES To involve second year dental students in assessing oral health knowledge, attitude, behavior, dietary habits and general health of dental patients, and screening for blood pressure, blood glucose level and obesity. PARTICIPANTS AND METHODS A convenient sample of 652 adult subjects participated in the study. They were screened, and involved in an interviewer - led questionnaire, led by the students over the period of two successive academic years (2013-2014 and 2014-2015). RESULTS Subjects with high blood pressure and /or blood glucose levels were more likely to disagree regarding the presence of a relation between general health and dental health [(correlation coefficient (r) = - 0.159, probability value P < 0.001) (correlation coefficient (r) = - 0.257, probability value P < 0.001) respectively]. Subjects with high BMI were less aware of the importance of using the tooth brush in prevention of gingival inflammation. The overall students' satisfaction score was 71.5%. The practical part of the research had the highest satisfaction score (83.7%). CONCLUSIONS There is scarcity of data regarding dental healthcare knowledge and attitudes in dental clinical settings. Additional clinical training for dental students would increase their willingness to play a preventive and educational role in the oral care of patients.
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Affiliation(s)
- M.M. FARGHALY
- Professor of Dental Public Health &Vice President of Community Service and Environmental Affairs
| | - A.S. BADRAN
- Lecturer of Pediatric Dentistry and Dental Public Health
| | - K. KERAA
- Biostatistician, Faculty of Oral & Dental Medicine, Misr International University, Cairo, Egypt
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Andersson H, Hedström L, Bergman S, Bergh H. The outcome of two-step blood pressure screening in dental healthcare. Scand J Public Health 2018; 46:623-629. [DOI: 10.1177/1403494818759840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: The purpose of this study was to evaluate a two-step screening method for hypertension in dentistry regarding the number needed to screen (NNS) and positive predictive value (PPV) and to risk-classify those with newly diagnosed hypertension. Methods: In connection with their regular dental care check-up, 2025 subjects aged 40–75 years were screened for high blood pressure. Via a health questionnaire, data were collected concerning risk factors. Blood pressure was screened comprehensively in two steps, which included screening in a dental clinic and home measurements for one week. Recently discovered hypertensive participants were assessed for 10-year risk of cardiovascular mortality according to the guidelines of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC). Results: A total of 170 new hypertensive participants were found (NNS = 12; 95% confidence interval (CI): 11–13). The method yielded a PPV of 0.73 (95% CI: 0.68–0.78) and eliminated 84.8% of the false-positive participants. The results also showed that based on ESH/ESC risk estimation, 76.5% of those newly diagnosed hypertensive participants had a moderate or high risk of cardiovascular mortality within 10 years. Conclusions: The study shows that a two-step method for blood pressure screening in a dental setting including home measurement resulted in a high PPV and eliminated most of those with a false high blood pressure reading. The findings also show that two-step screening for hypertension is feasible in a larger population with more screening providers involved.
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Affiliation(s)
- Helen Andersson
- Hallands Hospital Varberg, Sweden
- Primary Health Care Unit, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | | | - Stefan Bergman
- Primary Health Care Unit, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Håkan Bergh
- Primary Health Care Unit, The Sahlgrenska Academy, University of Gothenburg, Sweden
- Department of Research and Development Unit, Region Halland, Sweden
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Myers-Wright N, Lamster IB. A New Practice Approach for Oral Health Professionals. J Evid Based Dent Pract 2016; 16 Suppl:43-51. [PMID: 27236995 DOI: 10.1016/j.jebdp.2016.01.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
UNLABELLED The oral health care paradigm presented here would broaden oral health services to include primary health care activities focusing on risk reduction and chronic disease screening. BACKGROUND AND PURPOSE Changes in our nation's health care delivery system, shifting patient demographics, and availability of new health insurance programs have resulted in exploration of new practice models of health care delivery. Chronic diseases require coordinated care efforts over decades of a patient's life. Oral health professionals will be part of that care. METHODS The practice model for this article was developed in the context of an academic medical center that promotes oral health care professionals as health care providers through interprofessional education. The combined experiences of the authors, including a diabetes predictive model for oral health settings, the efficacy and effectiveness of human immunodeficiency virus screening in a dental setting, the feasibility of using a decision support tool for tobacco cessation, and the effectiveness of integrating oral health education with comprehensive health services for people living with human immunodeficiency virus, have contributed to this concept. CONCLUSIONS Prevention is increasingly recognized as a cost-effective means of reducing chronic disease burdens. To be effective, health promotion activities that encourage healthy living and early detection need to occur in a variety of health care settings. Oral health professionals represent an underutilized group of health care providers that can contribute to improved health of populations living with chronic diseases by broadening their scope of practice to include primary health screenings and tailored health promotion activities.
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Affiliation(s)
- Noreen Myers-Wright
- RDH, EdD, Department of Health Policy & Management, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Ira B Lamster
- DDS, MMSc, Department of Health Policy & Management, Mailman School of Public Health, Columbia University, New York, NY, USA
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An overview of the prison population and the general health status of prisoners. Br Dent J 2014; 217:15-9. [DOI: 10.1038/sj.bdj.2014.548] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2014] [Indexed: 11/08/2022]
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Hogan J, Radhakrishnan J. The assessment and importance of hypertension in the dental setting. Dent Clin North Am 2012; 56:731-45. [PMID: 23017548 DOI: 10.1016/j.cden.2012.07.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many patients with hypertension have uncontrolled disease. The dental visit presents a unique opportunity to screen patients for undiagnosed and undertreated hypertension, which may lead to improved monitoring and treatment. Although there are no clinical studies, it is generally recommended that nonemergent procedures be avoided in patients with a blood pressure of greater than 180/110 mm Hg. Because of the high prevalence of disease and medication use for hypertension, dentists should be aware of the oral side effects of antihypertensive medications as well as the cardiovascular effects of medications commonly used during dental visits.
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Affiliation(s)
- Jonathan Hogan
- Division of Nephrology, Department of Medicine, Columbia University College of Physician and Surgeons, New York, NY 10032, USA
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12
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Systemic health screening. Br Dent J 2012; 213:146. [DOI: 10.1038/sj.bdj.2012.730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ireland RS, Bowyer V, Ireland A, Sutcliffe P. The medical and dental attendance pattern of patients attending general dental practices in Warwickshire and their general health risk assessment. Br Dent J 2012; 212:E12. [PMID: 22538925 DOI: 10.1038/sj.bdj.2012.313] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2012] [Indexed: 11/09/2022]
Abstract
BACKGROUND The dental team could have an important role to play in general health risk assessment within primary and community healthcare.Aims To describe medical and dental attendance patterns, demographics and health profiles of patients routinely attending general dental practices in Warwickshire. To identify whether a subgroup attend dental practices regularly but attend medical practices infrequently and discuss whether preventive healthcare interventions delivered in general dental practice would be appropriate. METHODS A self-completion questionnaire was administered to patients attending 16 dental practices in Warwickshire. RESULTS Eight hundred and eleven completed questionnaires were returned (74% response). Seven hundred and eighty-nine (98%) respondents visited their dentist every one to two years or more frequently and of these a subgroup of 121 (15.3%) visited their general medical practice surgery or health centre less often than every two years. In the subgroup 9.5% reported high blood pressure, 17.6% currently smoked, 22% drank above recommended guidelines, 32.1% were overweight and 7.3% obese. DISCUSSION The data suggest there may be a role for dental practitioners in identifying patients at risk of having undiagnosed or future general health problems and providing appropriate general health advice, screening or signposting the patient to relevant general healthcare facilities either within or external to the dental practice.
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Affiliation(s)
- R S Ireland
- Warwick Dentistry, University of Warwick, Coventry, CV4 7AL
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Ezmek B, Arslan A, Delilbasi C, Sencift K. Comparison of hemodynamic effects of lidocaine, prilocaine and mepivacaine solutions without vasoconstrictor in hypertensive patients. J Appl Oral Sci 2010; 18:354-9. [PMID: 20835569 PMCID: PMC5349068 DOI: 10.1590/s1678-77572010000400006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2009] [Accepted: 02/16/2010] [Indexed: 11/26/2022] Open
Abstract
Objective Local anesthetic solutions with vasoconstrictors are not contraindicated in
hypertensive patients, but due to their hemodynamic effects, local anesthetics
without vasoconstrictors are mainly preferred by the clinicians. The aim of this
study was to compare hemodynamic effects of three different local anesthetics
without vasoconstrictors during tooth extraction in hypertensive patients. Material and Methods Sixty-five mandibular molars and premolars were extracted in 60 hypertensive
patients (29 females and 31 males; mean age: 66.95 ± 10.87 years; range: 38
to 86 years old). Inferior alveolar and buccal nerve blocks were performed with 2%
lidocaine hydrochloride (HCl), 2% prilocaine HCl or 3% mepivacaine HCl without
vasoconstrictor. Hemodynamic parameters namely systolic blood pressure (SBP),
diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR),
saturation rate (SR), rate pressure product (RPP) and pressure rate quotient (PRQ)
were investigated before and at different intervals after anesthetic
injection. Results The hemodynamic effects of the three agents were similar to each other, although
some significance was observed for DBP, MAP, RPP and PRQ values in the lidocaine,
prilocaine and mepivacaine groups. Conclusion Lidocaine, prilocaine and mepivacaine solutions without vasoconstrictor can be
safely used in hypertensive patients. It is advisable that dental practitioners
select anesthetic solutions for hypertensive patients considering their
cardiovascular effects in order to provide patient comfort and safety.
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Affiliation(s)
- Bahadir Ezmek
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
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Brand HS, Veerman ECI. Hypertension screening. Br Dent J 2010; 208:95. [DOI: 10.1038/sj.bdj.2010.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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16
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Non-invasive testing. Br Dent J 2010; 208:3. [DOI: 10.1038/sj.bdj.2010.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Woolcombe S, Koshal S, Bryant C, Rood P. Use of intravenous sedation in the management of patients with high blood pressure. ACTA ACUST UNITED AC 2009. [DOI: 10.1111/j.1752-248x.2010.01069.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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