03/08/2026
🚨 Would you treat a patient with a blood pressure of 180/110 mmHg?
Many dentists encounter hypertensive patients every day, but a few simple precautions can make treatment much safer.
💾 Save this post—you'll thank yourself during your next appointment.
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🩺 Before You Start
✅ Take a detailed medical history.
✅ Ask:
• Is your blood pressure controlled?
• Are you taking your medicines regularly?
• Any history of heart attack, stroke, chest pain, or heart failure?
✅ Record baseline blood pressure and pulse.
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📊 Blood Pressure Guide
🟢 Below 140/90 mmHg
✔ Routine dental treatment.
🟡 140–159 / 90–99 mmHg
✔ Routine treatment is generally safe.
🟠 160–179 / 100–109 mmHg
✔ Proceed with caution.
✔ Keep the patient relaxed and monitor BP.
🔴 180/110 mmHg or higher
❌ Postpone elective treatment.
✔ Refer the patient for medical evaluation.
✔ Provide emergency dental care only when necessary.
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💉 Local Anaesthesia
✔ Lidocaine (Lignocaine) with adrenaline is generally safe in controlled hypertension.
Remember:
• Aspirate before injecting.
• Inject slowly.
• Use the minimum effective dose.
• In significant cardiovascular disease, limit epinephrine to 0.04 mg (≈2 cartridges of 1:100,000).
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😌 Reduce Stress = Reduce Risk
✔ Morning appointments
✔ Short appointments
✔ Excellent pain control
✔ Explain the procedure
✔ Keep the patient calm
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💊 Painkillers
✅ Preferred:
• Paracetamol
⚠ Use NSAIDs (Ibuprofen, Diclofenac, Naproxen) cautiously, especially for prolonged use, as they may increase blood pressure and reduce the effectiveness of antihypertensive medications.
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💊 Common BP Medicines
• Amlodipine
• Telmisartan
• Losartan
• Enalapril
• Ramipril
• Atenolol
• Bisoprolol
• Metoprolol
• Hydrochlorothiazide
• Furosemide
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🦷 Oral Side Effects
• Gingival enlargement (especially with amlodipine)
• Dry mouth
• Altered taste
• Orthostatic hypotension (dizziness when standing)
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🪑 During Treatment
✔ Monitor patient comfort.
✔ Avoid sudden chair movements.
✔ Raise the chair slowly at the end of treatment.
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🚨 Medical Emergency
Stop treatment immediately if the patient develops:
❌ Chest pain
❌ Severe headache
❌ Shortness of breath
❌ Vision changes
❌ Confusion
❌ Blood pressure 180/120 mmHg or higher with symptoms
Activate emergency medical services if indicated.
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🎯 Key Takeaway
Most patients with well-controlled hypertension can safely receive routine dental treatment.
✔ Check BP.
✔ Reduce stress.
✔ Use local anaesthesia appropriately.
✔ Choose medications wisely.
✔ Treat with confidence.
📌 Follow for more evidence-based dental tips in my series: "Medical Conditions Every Dentist Should Know."
⚠️ This content is for educational purposes only and should not replace clinical judgment or current professional guidelines.
