Yes, many dentists routinely measure your blood pressure before a dental procedure or even a regular cleaning. This practice recognizes the interconnectedness of oral health and overall systemic condition. Checking this measurement serves as a routine safety precaution, allowing the dental team to assess your current physiological state. This screening helps ensure you are healthy enough to undergo the planned treatment without undue risk.
Why Blood Pressure Screening is Essential
The primary reason for screening is to prevent a medical emergency while you are in the dental chair. Dental appointments, especially those involving invasive work, can cause anxiety, which naturally raises blood pressure and heart rate. For individuals with undiagnosed or poorly controlled high blood pressure (hypertension), this stress-induced spike could trigger a serious cardiovascular event, such as a heart attack or stroke, during the procedure.
Hypertension is often called the “silent killer” because it frequently presents with no noticeable symptoms, meaning many patients are unaware of their condition. Dentists often see patients for routine cleanings more frequently than they visit their primary care physician. This regularity positions the dental office as an important secondary screening location, helping to identify potential cardiovascular issues. By taking this measurement, the dental team establishes a baseline and gains insight into your present cardiovascular health.
Handling Elevated Readings
When a patient’s blood pressure exceeds the normal range (below 120/80 mm Hg), the dental office follows specific protocols to ensure safety. For slightly elevated readings, such as Stage 1 Hypertension (systolic 130–139 mm Hg or diastolic 80–89 mm Hg), the dentist may proceed with routine care while closely monitoring the patient. If the reading is moderately high, such as Stage 2 Hypertension (systolic 140 mm Hg or higher or diastolic 90 mm Hg or higher), elective procedures like cosmetic work or non-urgent fillings are usually deferred. The patient is then informed of the reading and referred to their physician for evaluation and management before dental treatment can be completed.
A reading of 180/110 mm Hg or higher is considered a hypertensive urgency or crisis, representing a significant risk. If the reading is confirmed, all non-emergency dental treatment is postponed, and the patient is immediately referred for urgent medical evaluation. Only emergency procedures to address acute pain or infection may be considered, and only after consulting with the patient’s physician or with continuous, close monitoring.
Anesthesia and Vasoconstrictors
The blood pressure reading is a direct factor in the choice of local anesthetic used during the procedure. Most local anesthetics, such as lidocaine, contain a vasoconstrictor, most commonly epinephrine (adrenaline). This substance constricts blood vessels in the injection area, which prolongs the numbing effect and reduces bleeding at the surgical site.
Introducing a vasoconstrictor into the system of a patient who already has high blood pressure can be risky. Epinephrine can cause a transient increase in blood pressure and heart rate, potentially precipitating a severe hypertensive episode or an arrhythmia in a poorly controlled patient. For patients with controlled hypertension, the small amount of vasoconstrictor found in one or two anesthetic cartridges is considered safe. If a patient’s blood pressure is too high, the dentist may opt for an anesthetic formulation with a lower concentration of epinephrine or one that contains no vasoconstrictor to minimize cardiovascular stimulation.