Patient in Dental Pain with Uncontrolled Hypertension

By: Ashley Spooner, DDS

July 5, 2018

The Challenge:

To address the dental concerns to resolve patient’s dental pain. To educate the patient on the connection between dental health and overall health.

The Background:

  • Age: 37
  • Sex: M
  • Medical History: Hypothyroid, Hypertension, High Cholesterol, Snoring and trouble breathing while sleeping
  • Family History: Hypertension
  • Last Dental Exam: 01/29/2018
  • Home Care: Poor, Patient tends to seek dental care for emergencies only
  • Chief Complaint: Pain
  • Other Notes: Referred patient to a cardiologist due to uncontrolled hypertension and referred for screening for possible obstructive sleep apnea
  • Clinical Assessment: Multiple teeth with gross decay that require treatment
  • Periodontal Assessment: Generalized moderate chronic periodontitis
  • Medical Assessment: Patient is obese, has uncontrolled hypertension, should be screened for diabetes, and possible obstructive sleep apnea

The Solution:

  • Medical Referral to address hypertension and possible sleep complication
  • Date of Pre MyPerioPath®: 01/29/2018
  • Periodontal Therapy: Scaling and Root Planing with laser decontamination and irrigation
  • Amoxicillin and Metronidazole for 10 days each
  • Education: Discussed mouth-body connection with hypertension, diabetes, cholesterol, and overall not feeling well
  • Home Care: Sonicare, soft picks
  • Other Notes: Patient has improved home care and has not missed a follow up visit
  • Date of MyPerioPath® Progress (post-therapy test): 05/09/2018

The Result:

“Improved but not quite there yet.” Despite the patient’s noncompliance to the referral for medical evaluation, the patient’s blood pressure is decreasing post therapy. At his first appointment, the blood pressure reading was 156/105 and he had generalized moderate to severe inflammation with spongy, unhealthy gingiva. Now, at the last periodontal maintenance, the blood pressure reading was 119/82. He still has generalized moderate inflammation, but the improvement in heart health is encouraging. He has had some pocket depth decreases as well. The patient is now going to see our periodontist for additional evaluation. We are still insisting a medical evaluation and to continue periodontal care as well as treatment for sleep apnea here. We are not all of the way there, but the patient has improved in coming in for regular recalls and his oral hygiene is improving. We will continue to help the patient get the care he needs in order to help him to be happier and healthier overall!

About the Author:

Ashley Spooner, D.D.S is a graduate of the University of Colorado School of Dental Medicine; Aurora, CO. Dr. Spooner has experience in community care clinics and enjoys volunteering. At Falcon Park Dental Group, she strives to provide patients with an environment that is comfortable and geared toward each patient’s individual needs and wants. The office focus on total body health helps the team educate patients on the relationship of their dental conditions to total body health.