Cardiovascular responses induced by dental treatment

Cardiovascular responses in patients and dentists during dental treatment

Changes in mean heart rate and in mean systolic and diastolic blood pressure are induced by both the patient's anticipation of scheduled treatment and the actual dental treatment. Most of these changes are within the normal physiological variations, but significant changes are observed before administration of a local anaesthetic, during subgingival debridement and during extractions. Individual changes in heart rate and blood pressure are affected by age, gender, hypertension and previous dental experience. Pain also plays an important role in the cardiovascular response during dental treatment, which stresses the need for adequate analgesia. For this purpose, local anaesthetics with low concentrations of epinephrine seem preferable. They induce less pronounced cardiovascular responses than local anaesthetics with higher concentrations of epinephrine or without epinephrine. The changes in heart rate and blood pressure that occur in the dentist during the treatment are also discussed.

Cardiovascular changes during subgingival debridement

During dental hygiene sessions, systolic and diastolic blood pressure and heart frequency were registered continuously with a finger manometer to investigate the possible cardiovascular effects of root planing/scaling. Ultrasonic subgingival debridement was performed for an average period of 10.6 +/- 2.1 min. Analysis of variance showed significant changes of systolic and diastolic blood pressure, heart rate and the rate pressure product during debridement. The increases in systolic and diastolic blood pressure both correlated significantly with the length of the debridement. After completion of the dental hygiene session, the urinary excretion of adrenaline was increased. The data from this study suggest that painful stimuli during ultrasonic subgingival debridement have extensive cardiovascular effects.