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: 1/29/2018
- 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® (pre-therapy test): 1/29/2018
- Periodontal Therapy: Scaling and root planing with laser decontamination and irrigation
- Systemic Antibiotic Use: Amoxicillin and Metronidazole for 10 days each
- Education: Discussed Mouth-Body Connection™ with hypertension, diabetes, cholesterol, and overall not feeling well
- Home Care: Sonicare toothbrush and soft picks
- Other Notes: Patient has improved home care and has not missed a follow up visit
- Date of MyPerioProgress® (post-therapy test): 5/09/2018
The Result:
“Improved but not quite there yet.” 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 insisting a medical evaluation and to continue periodontal care as well as treatment for sleep apnea here. We are not all 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!
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