The Need for Accurate Data on Blood Pressure Measurement in the Dental Office

Comparison of perceived stress and oral health status using perceived stress scale and DMFT index between healthy, undiagnosed hypertensive, and known hypertensive dental patients

Subtle and asymptomatic nature of high blood pressure results in increase in mortality and morbidity. Dentists may play a vital role in identifying patients with suspected hypertension who are not yet diagnosed to refer them timely to physicians for diagnosis and management of the condition. The aim of this study was to compare the oral health status using decayed, missing, filled teeth (DMFT) index and perceived stress score using perceived stress scale (PSS-10) between systemically healthy dental patients, and patients with undiagnosed and known hypertension attending dental out-patient department of Combined Military Hospital (CMH) Lahore Medical College & Institute of Dentistry, Lahore, Pakistan. It is a cross-sectional descriptive study in which 108 patients participated selected through purposive sampling method, 36 in each group. According to Kruskal Wallis H test, there were significant associations seen among the three groups with age (p < 0.001), DMFT (p < 0.001), and PSS-10 scores (p = 0.003). According to Spearman's matrix correlations, moderate positive correlations were observed between mean arterial pressure (MAP) and DMFT (r = 0.46, p < 0.001), and MAP and age (r = 0.38, p = 0.001), DMFT and PSS-10 (r = 0.47, p < 0.001), and DMFT and age (r = 0.33, p = 0.004) in healthy and patients with undiagnosed hypertension. It may be concluded that patients with raised blood pressure have higher perceived stress and deteriorated oral health.

Human Errors in Automated Office Blood Pressure Measurement: Still Room for Improvement

In this review of the literature and commentary, we examine the literature on automated blood pressure (BP) measurements in the office and clinic. Our purpose is to revisit issues as to the pros and cons of automated BP measurement published in Hypertension in June 2020 and to identify areas needing additional research. Despite initial reservations about automated BP, it is here to stay. A number of experts suggest that human error will be reduced when we move from the more complex skills required by aneroid sphygmomanometer measurement to the fewer skills and steps required by automated BP measurement. Our review indicates there is still need for reduction in errors in automated BP assessment, for example, retraining programs and monitoring of assessment procedures. We need more research on the following questions: (1) which classes of health care providers are least likely to measure BP accurately, usually by ignoring necessary steps; (2) how accurate is BP assessment by affiliated health care providers for example the dental office, the optometrist; and (3) why do some dedicated and well-informed health care professionals fail to follow simple directions for automated BP measurement? We offer additional solutions for improving automated BP assessment in the office and clinic.