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Old 10-30-2019, 10:42 AM
 
611 posts, read 518,326 times
Reputation: 1030

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Quote:
Originally Posted by xz2y View Post
Also, I think it's important that a dental office inform patients beforehand that if their BP readings are what they consider to be "high," they could be denied dental treatment, if that's their policy. I'm not sure if these are state laws or just policies that vary from practice to practice.

I do know that as I am researching retirement locations and calling dental offices for prices, I will now ask about their BP policy and if denial of services can happen based on BP readings.

BP readings also vary throughout the day, and more than one should be taken to get a more accurate assessment of BP. I've also had the situation where the automated cuffs read consistently higher than when a professional does a manual cuff reading. Wrist cuffs are not accurate from what I've read. And taking the BP over clothing is also not advised. However, in a dentist's office, taking off a shirt to get to a bare arm is not always possible, so that becomes another issue.

Personally, I think all dental patients need to be informed ahead of time that BP readings will be taken prior to any dental services and that services can be denied. This should not be a "surprise" at any dental visit.
1) If the dentist informs the patient of that, then they should also inform the patient of every other reason why your treatment could be denied, which would be a heck of a long list. Instead, virtually every dentist posts a sign or has a part in their paper work that says something like "We reserve the right to refuse treatment to anyone." Thus, it should not be a "surprise" since you either saw the sign or you signed the paperwork indicating that you read it and understand it. If you either didn't read the posted sign or just skimmed the paperwork then that's on you.


2) Also, keep in mind that the dentist absolutely hates it when they can't do the scheduled treatment because of a patient-related problem. You think they want that chair to go empty for an hour? Of course not. Empty chair means no money coming in and the staff still expects to get paid for that hour. They are trying to help YOU not have a problem, even though it is costing them time and money.


3) As far as the BP cuff goes, just wear a short sleeve shirt/blouse to your appointment. If it is cold outside, wear a jacket/coat. We offer blankets to anyone who gets old in the office.
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Old 10-30-2019, 11:07 PM
 
1,246 posts, read 462,340 times
Reputation: 540
Quote:
Originally Posted by xz2y View Post
I have the "white coat" higher readings also, but now I track my BP at home with a nice little Omron BP device, and keep a spreadsheet with all the readings. My readings at home are totally normal. So, I take the spreadsheet to any dr or dentist appointment and show it to them, and offer to give them a copy for my chart. Usually that will solve the issue of high readings in the dentist office. I've not had any dentist turn me away due to a high reading when I've brought my spreadsheets.

Also, it's important to remember that BP equipment can vary between offices and also how the BP is taken by the assistant. Readings will be all over the map if not taken correctly.
I used to take my pressure at home but maybe I just didn't do it right. I know what they say about white coat syndrome, but I can't figure it's much different from my readings at home, and I wouldn't want to medicate myself.
Yes, when I went to the dentist a few months ago, they found my pressure sky rocketing, I was ready for the ER. But I went back to my doctor and sadly had to go back on my meds. I guess this time I'll be taking them for the rest of my life instead of playing around with them and not taking them when I don't feel like it. (Oh, well.)
As far as white coat syndrome, I guess I'll know if my pressure readings are one thing at the doctor's office (in a more normal range) and sky rocketing at the dentist's office. :-)
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Old 10-30-2019, 11:10 PM
 
1,148 posts, read 324,538 times
Reputation: 1514
Quote:
Originally Posted by Eye-duh-hoe View Post
I currently live in Colorado and they require blood pressure readings. I have been turned down by 2 dentists because I get super high BP readings at the dentists and drs. offices. I've had pretty bad anxiety and white coat syndrome all my life. I have a root canal that is in desperate need of repair and I feel I can't do anything about it. I've been considering going out of state just for dental work. Do you know if any states or maybe your dentist that doesn't check BP. I know this seems silly and ridiculous but thought I would check.

Thanks!
Ask your dentist to prescribe Diazepam so you can take the pill beforehand.I am taking a lady to the dentist tomorrow who is going that route just for a cleaning. Yet she doesn't have high blood pressure.

My husband has high blood pressure and he was forced to get it under control first before having dental work done. Or maybe it was just a cleaning, I've forgotten

Good luck!
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Old 10-31-2019, 07:50 AM
 
611 posts, read 518,326 times
Reputation: 1030
Quote:
Originally Posted by SaraR. View Post
Ask your dentist to prescribe Diazepam so you can take the pill beforehand.I am taking a lady to the dentist tomorrow who is going that route just for a cleaning. Yet she doesn't have high blood pressure.

My husband has high blood pressure and he was forced to get it under control first before having dental work done. Or maybe it was just a cleaning, I've forgotten

Good luck!
This is considered to be a form of conscious sedation. Depending on your state, your dentist might need a specific sedation permit to do this, which requires additional training and monitoring equipment.
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Old 10-31-2019, 08:23 AM
 
Location: A safe distance from San Francisco
9,729 posts, read 6,797,753 times
Reputation: 10332
Quote:
Originally Posted by Eye-duh-hoe View Post
I currently live in Colorado and they require blood pressure readings. I have been turned down by 2 dentists because I get super high BP readings at the dentists and drs. offices. I've had pretty bad anxiety and white coat syndrome all my life. I have a root canal that is in desperate need of repair and I feel I can't do anything about it. I've been considering going out of state just for dental work. Do you know if any states or maybe your dentist that doesn't check BP. I know this seems silly and ridiculous but thought I would check.

Thanks!
Not silly and ridiculous at all - at least not on your part. I went through the same thing 4 years ago when I went to get a tooth pulled.

My solution was to get an appointment with the same oral surgeon that had pulled my last tooth about 20 years ago. He is semi-retired, but works every now and then with the group that took over his practice. He has a perspective on these things that is getting very difficult to find. I also got a prescription for diazepam (valium) to take an hour before the visit. That helped a little, but my BP was still high. Always has been when measured in a medical setting (kept me out of Viet Nam) and will be to the day I die. My wise old surgeon went ahead and pulled the tooth anyway....and there was very little bleeding.

My impression was that this had become fairly common practice in recent years, but was totally at the descretion of the provider. My experience was here in California. Are you saying Colorado now has some sort of legislative mandate?

Best of luck to you....I know this is infuriating to deal with. And, of course, that fact alone essentially makes it a problem with no solution....outside of finding a provider who can think and work with you as an individual....respectfully.
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Old 10-31-2019, 08:59 AM
 
5,635 posts, read 2,469,257 times
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Quote:
Originally Posted by CrownVic95 View Post
Not silly and ridiculous at all - at least not on your part. I went through the same thing 4 years ago when I went to get a tooth pulled.

My solution was to get an appointment with the same oral surgeon that had pulled my last tooth about 20 years ago. He is semi-retired, but works every now and then with the group that took over his practice. He has a perspective on these things that is getting very difficult to find. I also got a prescription for diazepam (valium) to take an hour before the visit. That helped a little, but my BP was still high. Always has been when measured in a medical setting (kept me out of Viet Nam) and will be to the day I die. My wise old surgeon went ahead and pulled the tooth anyway....and there was very little bleeding.

My impression was that this had become fairly common practice in recent years, but was totally at the descretion of the provider. My experience was here in California. Are you saying Colorado now has some sort of legislative mandate?

Best of luck to you....I know this is infuriating to deal with. And, of course, that fact alone essentially makes it a problem with no solution....outside of finding a provider who can think and work with you as an individual....respectfully.
They do this partially to know how epinephrine will affect you with the anesthetic, as it can (and often does) raise blood pressure. It is possible to get anesthetic without the epinephrine, but it does not last more than 20-30 minutes and you may bleed more, so it is not appropriate for all procedures. I have had it for a gum surgery (ran out) and cavity (worked fine). I prefer not to have the epinephrine because it takes forever for me to metabolize it and I am numb most of the day. For a big gum surgery I will get it, but for a cavity, forget it.
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Old 10-31-2019, 09:56 AM
 
Location: A safe distance from San Francisco
9,729 posts, read 6,797,753 times
Reputation: 10332
Quote:
Originally Posted by RamenAddict View Post
They do this partially to know how epinephrine will affect you with the anesthetic, as it can (and often does) raise blood pressure. It is possible to get anesthetic without the epinephrine, but it does not last more than 20-30 minutes and you may bleed more, so it is not appropriate for all procedures. I have had it for a gum surgery (ran out) and cavity (worked fine). I prefer not to have the epinephrine because it takes forever for me to metabolize it and I am numb most of the day. For a big gum surgery I will get it, but for a cavity, forget it.
Regardless of the theoretical reason(s) they think they have for doing this now when for many decades they never did, all they have done, in real-world effect, is turn their offices into much more effective and thorough high blood pressure factories than they already were. And they already were doing a bang-up job at that.

They've accomplished nothing but to increase the very small risk of a blood-pressure related issue in or immediately following a dental procedure. I've had high BP in all medical office settings all my life and nonetheless had teeth pulled on 3 separate occasions 20+ years ago with no mention of BP whatsoever. They went smoothly and easily. If they had made an issue of BP, it would have been 50 points higher....as it was 4 years ago when I faced this new policy for the first time myself.

They're putting people at more risk, not less, both by raising BP even higher than it otherwise would be AND by simply keeping many more people away from dental offices.
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Old 10-31-2019, 10:52 AM
 
611 posts, read 518,326 times
Reputation: 1030
Quote:
Originally Posted by CrownVic95 View Post
Not silly and ridiculous at all - at least not on your part. I went through the same thing 4 years ago when I went to get a tooth pulled.

My solution was to get an appointment with the same oral surgeon that had pulled my last tooth about 20 years ago. He is semi-retired, but works every now and then with the group that took over his practice. He has a perspective on these things that is getting very difficult to find. I also got a prescription for diazepam (valium) to take an hour before the visit. That helped a little, but my BP was still high. Always has been when measured in a medical setting (kept me out of Viet Nam) and will be to the day I die. My wise old surgeon went ahead and pulled the tooth anyway....and there was very little bleeding.

My impression was that this had become fairly common practice in recent years, but was totally at the descretion of the provider. My experience was here in California. Are you saying Colorado now has some sort of legislative mandate?

Best of luck to you....I know this is infuriating to deal with. And, of course, that fact alone essentially makes it a problem with no solution....outside of finding a provider who can think and work with you as an individual....respectfully.
And why would that provider want to jeopardize his/her license just to placate you? In my state, it is mandated by the state dental board to take BP/Pulse at every examination. Whether I think this rule is stupid or inconveniences you or me is out of my control. Take it up with your congressman.


So many people on this forum love to tell their anecdotes about how their experience turned out just fine. Cool story bro. It does not turn out just fine for everyone, everywhere.
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Old 10-31-2019, 12:26 PM
 
2,900 posts, read 1,632,855 times
Reputation: 12658
Quote:
Originally Posted by CrownVic95 View Post
Regardless of the theoretical reason(s) they think they have for doing this now when for many decades they never did, all they have done, in real-world effect, is turn their offices into much more effective and thorough high blood pressure factories than they already were. And they already were doing a bang-up job at that.

They've accomplished nothing but to increase the very small risk of a blood-pressure related issue in or immediately following a dental procedure. I've had high BP in all medical office settings all my life and nonetheless had teeth pulled on 3 separate occasions 20+ yearsago with no mention of BP whatsoever. They went smoothly and easily. If they had made an issue of BP, it would have been 50 points higher....as it was 4 years ago when I faced this new policy for the first time myself.

They're putting people at more risk, not less, both by raising BP even higher than it otherwise would be AND by simply keeping many more people away from dental offices.

I was checking BP in dental offices in the 70s, so it is hardly new, and the reason for it is not theoretical...it's good policy, whether you understand it or not.



There are things you don't know, you know.
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