I had never heard of dentists checking blood pressures and heart rates… who would have thought?? Well, apparently many dentist offices realize the impact that they can have on the health of their patients. I recently asked my personal dentist if this was something that they did at their office and he replied that if a patient had a relevant medical history or had advanced age without regular medical checkups, he would check a blood pressure before performing any procedure on the patient. Interesting.
This all came to light after we had a patient present to our hospital for a diagnostic cardiac catheterization. He had originally gone to his dentist where they had checked his blood pressure and found that it was very high. They referred him to a cardiologist who started a work-up to find if there were any other medical conditions and found that he had a positive stress test and a CT scan showed that he had a large aneurism in his abdominal aorta. So, he was referred to a vascular surgeon to fix his aneurism, but since he had a positive stress test, the surgeon insisted that he get cardiac clearance from a cardiologist before surgery. His cardiologist then brings him to the hospital for a cardiac catheterization, which showed severe disease in multiple coronary arteries and a need for a coronary bypass (open heart surgery). So, he was placed in the ICU for a few days while the vascular surgeon and the cardiac surgeon ran tests and discussed which was better for the patient: to fix the aneurism or fix his blocked coronary arteries first. And this is where the patient sits at this point, it’s been two days and we’re waiting for a set of test results.
If the patient’s dentist didn’t find the high blood pressure and recommend that the patient get it checked out, then the aneurism could have very easily ruptured, probably causing sudden death, or he could have had a massive heart attack from the blockage in his coronary arteries. The more that we can do to make patients fully aware of medical conditions they have, or might have, the more informed decisions they are able to make about their health. We see patients all the time who come in as smokers, drinkers, and/or children of people who died of heart disease saying “I was totally healthy before this heart attack” only because they hadn’t seen a physician in 15 years. If they had known that their cholesterol level was over 300, they could have been placed on a daily pill to help decrease their risk of this huge heart attack they just had.
The first experience I had with this was in the oral surgeon’s office (teeth to be yanked). I think it’s a very good idea. The shot drove my BP up more than the actually tooth removal (hey, I was NUMB then), but I could see where a tough procedure could put some patients w/heart trouble at risk. The BP measurement is a good safety check.
OK, yes, good idea. But please, please do not send patients to the ER just because you find that their BP is180/100 (at the dentist’s office, no less). Because, guess what? we don’t treat hypertension in the ER unless something else is going on.