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                                                        DR. DAN PETERSON

                                                                      1415 SAGE STREET ~ GERING, NEBRASKA 69341 
                                                             
      Call: 308-436-3491       www.dentalgentlecare.com           

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MONITORING BLOOD PRESSURE 
IN THE DENTAL OFFICE-WHY?

     This is a service we do for our patients free of charge.  This free service to you cost our office about $1,200 in salary and lost production a month to perform*.  Why do we do this?  Because we care about you and your health.

     Hypertension or high blood pressure is a consistent reading of 120/80 or higher. Normal blood pressure is approximately 120/80.  If you have a reading above 120/80 we will suggest you consult with your physician about your blood pressure. One quarter of the US population has high blood pressure yet show no obvious symptoms.  This is why it is called the "silent killer".  It is of world-wide epidemic proportions. The ADA recommends that any patient with a reading of 180/110 is the cutoff point for offering urgent treatment without medial consultation.

Blood Pressure
Classification
SBP (mm HG) DBP (mm Hg)  
Normal <120  and <80  Regular care;
Prehypertension 120-139 or 80-89  Advise pt of BP status; recommend lifestyle modifications
Stage 1 Hypertension 140-159 or 92-99  Regular care; recommend physician consult; stress reduction protocol
Stage 2 Hypertension > 160 or>100 Re-check BP in 5 min.s; non-invasive care only; definitive emergency care only if less than 180/110; refer to physician for immediate followup; stress reduction protocol
Hypertensive Crisis 220+  120+  Re-check BP in 5 min.s; no dental therapy, routine or emergency, until elevated BP is corrected; manage emergency w/ antibiotics and/or analgesics; hospitalization and immediate BP reduction when signs & dx of organ damage are present; otherwise refer to physician for immediate followup #

Hypertension alone is the most important risk factor for heart failure.  Hypertension is the leading cause of strokes, kidney failure and blindness.  Having high blood pressure increases stroke risk four to six times!

Why do we take your blood pressure?  Because 1 in 3 people have high blood pressure and don't know they have it.

One in three people have hypertension and do not know it.  Dentist are a great source to screen for this common and dangerous condition.

     Hypertension applies stress on blood vessel walls  which decreases the diameter of the blood vessels while keeping the volume of blood flow constant which increases the velocity of blood traveling down the vessels which increases pressure on the vessels walls  leading to strokes from blood clots or  a hemorrhage.

bulletThe risk of developing cardiovascular disease doubles for every increment of 20 mm Hg of systolic blood pressure or 10 mm Hg of diastolic blood pressure 
bulletSystolic blood pressure higher than 140 Hg in people older than 50 years of age is more important risk factor than diastolic pressure
bulletPeople with normal blood pressure at age 55-65 years have an 80-90% risk of developing hypertension by age 80-85.
bulletIf your blood pressure is usually 145/95, most life insurance companies double your premium because your life span would likely be shorter than that of someone with normal blood pressure. If your systolic blood pressure is over 200, there is a much higher risk that you will have a stroke, which can lead to impaired mental or physical function, or even cause death 
bulletCases probably should not be started if you have blood pressure values above 200 mm Hg systolic or 100 mm Hg diastolic. Many patients will have an increase in blood pressure of 10% during or immediately after administration of local anesthesia.

     Hypertension has three primary risk factors: tobacco use, poor nutrition, and lack of exercise, all of which are reversible and correctable.

If you have hypertension:

bullet The best time to come for dental treatment if you have high blood pressure is in the afternoon. Thus afternoon appointment are recommended over mornings for this reason.
bulletYour blood pressure will be taken at each visit.  The best arm to use the monitor on is on the left arm.
bulletStress reduction protocol will be followed which includes:
bulletshorter appointments
bulletgood night's sleep before the appointment
bulletavoiding caffeine before the appointment
bulleteating a regular meal before the appointment
bulletample time allowed to get to your appointment
bulletpremed as needed
bulletchecked to make sure daily hypertensive medications were taken 
bulletraising dental chair slowly
bulletallowed to sit upright in dental chair for several minutes after procedure to avoid hypotension
bullet  Anxiety and stress associated with dental treatment typically causes a rise in blood pressure.  Using of a sedative the night before treatment may help.
bullet  Also using nitrous oxide 10 minutes before treatment may reduce blood pressure to acceptable levels, allowing initiation of local anesthesia.

     The most effective strategy that can aid to control hypertension and it's substantial decline is the ability to detect, evaluate and treat people early with accurate blood pressure measurements. So we offer this service to help you monitor your health because we value you.

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Update:

Hypertension

Hypertension has few discernable symptoms before events like strokes or heart attacks. Most individuals are often unaware of the symptoms associated with hypertension and tend to be unaware of theircondition  if they do not receive regular blood pressure screenings.

Blood pressure checks are easy to incorporate into routine hygiene examinations.  Through hypertension specific organs are targeted for damage, such as heart, brain, kidneys, peripheral arteries and the eyes

Anti-hypertension therapy typically involves referral, medication, lifestyle changes and monitoring. Treatment is effective.

Hormone changes in women, especially during pregnancy and while taking birth control can increase blood pressure and the risk of hypertension.

Hypertension is also becoming a problem with the increasingprevalence of overweight children.

So what is normal? A systolic pressure of less than 120 and a diastolic pressure of less than 80.
The research has shown that the
systolic blood pressure number is the better indicator of decreased risk.

Berger EK  Contemporary Oral Hygiene 2004;4(6)10-11
 

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Hypertension affects one in four Americans. A new report suggests that eating 3 - 4 servings of dairy each day as part of a healthy diet may help to reduce the risk of nine common diseases and conditions including hypertension and obesity, resulting in healthcare cost savings of as much as $26 billion in the first year. ADA 2/04

Check the Numbers
Even if you think you have your blood pressure under control, you may want to revisit the numbers.

The U.S. government has recently revised its definition of high blood pressure to include numbers previously considered ideal. Now, any reading of 120/80 mm Hg or higher is considered something to watch or to treat. Have your blood pressure checked soon to see how it stacks up against the new numbers.

RealAge Benefit: Keeping your blood pressure at 115/76 mm Hg can make your RealAge as much as 12 years younger.

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Sweet taste boots adults' pain tolerance EXCEPT in those with high blood pressure!

According to research presented at the American Psychosomatic Society's, sweet-tasting solutions seem to be analgesic in adults, especially adults with lower than average blood pressure. However the findings of this study also discovered that  people with high blood pressure or even just a tendency toward higher blood pressure may not be buffered from pain by the sweet taste because they have a reduced response to natural painkillers. Consistent with the notion that people with high blood pressure have different functioning of (natural painkillers), individuals with higher blood pressure are less sensitive to this effect 
ADA Today's News; Reuters March 2002.

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Most Adult Diabetics In United States Have Hypertension
Nearly three-quarters of adult diabetics in the United States have hypertension. Regardless of age, sex, race or ethnic origin, all may benefit from efforts to prevent it.

Potassium Content of Foods:

HIGH potassium more than 225 milligrams

All meats, poultry and fish are high in potassium.
Apricots (fresh more so than canned)
Avocado 1/4 small
Banana 1 small
Cantaloupe 1/4 small
Pumpkin 1/2 cup
Dates 5
Peach 1
Nuts all kinds 1/2 cup
Grapefruit
Honeydew 1/8
Mango 1 small
Papaya 1 medium
Artichoke 1 medium
Beet greens 1/4 cup
Winter squash 1/2 cup
Bouillon 1 cup
Dried fruit 1/4 cup
Chili 1/2 cup
Lasagna 1 cup
Kiwi 1
Lima beans 1/2 cup
Corn on cob 1 ear
Milk 1 cup
Oranges and orange juice |
Potatoes 1/2 cup
Prunes 1/4 cup
Spinach 1/2 cup
Tomatoes products 2 tbsp
Vegetable juice 1/2 cup
Winter squash 1/2 cup
Molasses 1 tbsp
Sweet Potatoes or Yam 1 cup
Pizza 2 slices
Salt substitute 1/4 tsp
Soya milk 1 cup
Spaghetti 1 cup
Yogurt 6 oz
Apricots 3 medium
V8 juice

MODERATE (125 - 225 mg per serving 1/2 cup)
Apple juice
Asparagus
Beets
Blackberries
Broccoli
Carrots
Cherries
Corn
Eggplant
Grapefruit
Green peas
Loose-leaf lettuce
Mushrooms, fresh
Onions
Peach
Pears
Pineapple
Raisins
Raspberries
Strawberries
Summer squash, including zucchini
Tangerines
Watermelon

Resource:

#General Dentistry, Nov.-Dec. 2004; Vol. 52, no. 6; pages 544-552.
New National Guidelines on Hypertension, Dr. Herman, Konzelman, Prisant, JADA, Vol 135, og576-586 May 2004
Dentistry Today, Dental Hygiene and Hypertension, pg 46, September 2002
Dentistry Today, Monitoring Blood Pressure in the Dental Office, Dr. Perkins September 2001 pg 148-151
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February 06, 2008

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          If you have any questions please e-mail me at: drdpeterson@scottsbluff.net
                                                                                 308-436-3491 Office number

PLEASE NOTE: The information contained herein is intended for educational purposes only.  It is not intended and should not be construed as the delivery of dental/medical care and is not a substitute for personal hands on dental/medical attention, diagnosis or treatment.  Persons requiring diagnosis, treatment, or with specific questions are urged to contact your family dental/health care provider for appropriate care.
This site is privately and personally sponsored, funded and supported by Dr. Peterson.  We have no outside funding.
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