Dental Management of a Hypertensive Patient

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  • #17501
    Anonymous

    When it is concerned with the management of these patients all appointments should be sheduled in the early morning after the intake of particular table prescribed by physician,while extraction use Plane anesthetics without adrenaline. Only controlled BP patients are allowed to undergo any kind of treatment. The side effect of Calcium chal blockers in the form of generalized ging enlargement should also be taken care

    #17508
    tushard8
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    Registered On: 15/07/2011
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    patients on medication for hypertension are often prescribed anticoagulants like aspirin or clopidogrel. thorough history taking by dentist can avoid any complications due to these drugs.

    #17521
    drmittal
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    Registered On: 06/11/2011
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    Abstract
    Background
    While dental treatment has been reported to lower inflammatory marker levels, such studies were small and did not involve subjects with cardiovascular diseases. The present prospective study examined the effect of interventional dental treatment on serum C-reactive protein (CRP) and fibrinogen levels in patients with essential hypertension.

    Methods
    The study enrolled 50 subjects (age: 53.1±7; 23 men and 27 women) diagnosed with moderate or severe essential hypertension. Patient clinical characteristics were as follows: 80% had hypercholesterolemia, 72% were obese/overweight, 6% had diabetes mellitus, 16% were current smokers, 40% had target organ damage, and the overall general dental health status was poor. CRP and fibrinogen levels were assessed prior to treatment and again after 6 months. Dental treatment was mainly for periodontal disease and dental caries and its complications, and consisted of extractions of hopeless teeth, supragingival scaling, subgingival curettage, anti-inflammatory rinses and metronidazole treatment. There was a mean 4 treatment sessions per patient over 11 weeks.

    Results
    Dental treatment resulted in improved sulcus bleeding index (51±19 vs. 42±17, p<0.001) and approximal plaque index (50±23 vs. 42±13, p<0.001) scores, but had no effect on CRP (1.66 vs. 1.2 mg/l, p=0.44) or fibrinogen (3.27 vs. 3.22 g/l, p=0.08) levels.

    Conclusions
    We suggest that the lack of effect of dental treatment on CRP and fibrinogen levels could have resulted from smaller impact of dental disease on the total inflammatory burden in the presence of hypertension and other cardiovascular risk factors.

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