Dentistry and Hypertension : Relationship

EFFECTS OF HYPERTENSION AND MEDICATIONS ON ORAL HEALTH

It is an unfortunate trade off in life that as we age and acquire more wisdom and experience, we also increase the likelihood of having health problems.

Senior citizens are more likely to have high blood pressure and be taking multiple medications than when they were young. Seniors should be prepared and informed when they go to their dentist for treatment.

A very large group of population, many who are seniors, suffer from high blood pressure, or hypertension. Hypertension, often referred to as the "silent killer," is defined by repeatedly having a blood pressure reading greater than 140/90. Hypertension is dangerous because it increases the risk of heart attack, stroke, kidney and eye damage. A person can have hypertension for years and not know about it because there are little or no symptoms.

People with hypertension are generally advised to reduce salt intake, lose weight, and increase aerobic exercise. If these measures are not sufficient, a number of drugs are needed to reduce the blood pressure. The main drugs given to hypertensive patients are diuretics, beta-blockers, calcium channel blockers, and angiotensin converting enzyme (ACE) inhibitors. These drugs reduce blood pressure by decreasing blood volume, decreasing the force of heart contractions, and relaxing blood vessel walls, respectively.

As Dentists, we are concerned with how well-controlled the hypertension is. Patients with poorly controlled hypertension will often bleed more after routine oral surgery. Patients who take hypertensive drugs may be more sensitive to the small amounts of epinephrine in dental anesthetics as well as need a greater level of assistance when being elevated in a dental chair from a supine (lying on the back) position.

Many medications used by seniors, as well as some diseases, can cause the mouth to become dry. Saliva protects the mouth because it helps wash away food, neutralize bacterial acids, and lubricates the mouth. A lack of saliva in the mouth increases the chance of developing cavities, gum disease, irritations in the mouth, and it also makes it more difficult to wear dentures, speak and swallow food.

Some of the types of medications that can cause dry mouth are antihistimines, antidepressants, painkillers, diuretics (water pills) and decongestants, to name a few. Disease conditions such as Sjogren's Syndrome and radiation treatment in the head and neck region can also cause dry mouth. Your dentist can recommend certain methods to restore moisture. Consider sugar-free lozenges or gum, and artificial saliva can be used in some cases. Brushing your teeth and flossing are extremely important, as is the use of a fluoride containing mouth rinse. In some cases, the use of a custom-made mouth tray worn before bed is needed to deliver a higher dose of fluoride to protect the teeth and gums.

Today's dentist needs to work closely with the senior's medical doctor and specialists to ensure safe and effective senior dental care. It is import to inform your dentist about any health conditions you have, and the medications you are taking. Your dentist should be aware of the special needs, and potential problems that seniors face.