Patient with Dental Pain, Periodontal Disease & High Blood Pressure

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.

Background: The patient is a 37-year-old male who presented with a dental pain emergency. The home care is poor and patient has history of only seeking dental care for emergencies. Medically, the patient has hypothyroidism, hypertension, high cholesterol and significant difficulty breathing while asleep. The blood pressure reading on 1/29/2018 was 156/105. During the periodontal assessment, generalized heavy bleeding with probe depths measuring 4-8 mm were recorded.

Solution: We referred the patient for medical evaluation to address the elevated blood pressure reading. We collected a specimen for OralDNA® Labs’ MyPerioPath® on 1/29/2018 to determine the bacterial cause of the periodontal inflammation. The periodontal therapy consisted of scaling and root planing with laser decontamination and irrigation. The recommended systemic antibiotic of Amoxicillin and Metronidazole was taken and completed by the patient in 10 days. Extensive education on the mouth-body connection and home care instruction was addressed during several appointments. A MyPerioProgress®, a post-therapy MyPerioPath® was secured on 5/9/2018.

Results: “Improved but not quite there yet.” Despite the patient’s noncompliance to the referral for medical evaluation, the patient’s blood pressure decreased 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.  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 decrease as well.  The patient is now going to see our periodontist for an additional evaluation.  We are still insisting a medical evaluation be completed along with periodontal care as well as sleep apnea treatment at this office.  We are not all of the way there, but the patient has improved his compliance for appointments 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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Ashley Spooner DDS