Management of the hypertensive patient in dentistry: narrative review

Abstract

Purpose: Considering the issues surrounding the treatment of a patient with hypertension in the dental setting, this narrative review aims to highlight what approaches and guidelines should be kept in mind when approaching a hypertensive patient.

Methods: All articles and reviews considering the topic of hypertension management in dentistry were searched on the online platform of scientific reading sites such as PubMed and Medline, selecting the most current ones, up to January 2022, including any language. Considering the keywords "hypertension," "Dentistry," "blood pressure' and "posology," randomized controlled trials (RCTs), prospective studies, observational studies, reviews, and retrospective studies were considered. Textbooks relevant to the topic were then examined, and the citations of each retrieved article and those of reviews and expert opinions were examined to include as much knowledge as possible.

Result: by analyzing the literature data, it could be inferred that hypertension should be carefully attended to and treated with appropriate precautions especially in the pre-surgical phase. 

Conclusion: controlled hypertension does not represent a contraindication to dental and surgical treatment; nevertheless, in some cases, pressure abnormalities due to severe stress attributable to the hospital environment (white coat hypertension) can be found, which if they were to lead to a pressure higher than 200 mmGH in the pre-surgical phase should lead to the cessation of clinical treatment.