Little J W
University of Minnesota, Minneapolis, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Nov;90(5):591-9. doi: 10.1067/moe.2000.109517.
Dentistry has played an important role in the detection of patients with hypertension. Patients found to have high blood pressure at or beyond defined levels should be referred for a medical diagnosis and indicated treatment. Once the hypertensive condition is under control, oral and dental evaluation and treatment can be initiated. Beginning in 1976, the percentage of the general population in the United States with undetected hypertension declined steadily. However, this decline reversed, beginning in 1994. In addition, fewer than 50% of the patients who are aware of their hypertension have it medically under control. Thus, a significant number of patients with undetected high blood pressure or uncontrolled hypertension today are seeking dental treatment. These patients are at high risk for significant complications such as stroke, heart disease, kidney disease, and retinal disease. Those with very high blood pressure are at great risk for acute medical problems when receiving dental treatment. For those reasons, dentistry must continue to place an emphasis on the detection and referral of patients with high blood pressure. In addition, increased numbers of medically compromised patients are seeking dental treatment who should have their blood pressure monitored during the more stressful dental procedures, such as oral surgery, periodontal surgery, and placement of dental implants. This article reviews the recent advances in the dental and medical management of hypertension. It is important for dentists to be aware of hypertension in relation to the practice of dentistry.
牙科在高血压患者的检测中发挥了重要作用。被发现血压达到或超过规定水平的患者应转诊进行医学诊断并接受相应治疗。一旦高血压病情得到控制，即可开始进行口腔和牙科评估及治疗。自1976年起，美国未被检测出患有高血压的普通人群比例稳步下降。然而，从1994年开始，这种下降趋势发生了逆转。此外，知晓自己患有高血压的患者中，不到50%的人其病情得到了医学控制。因此，如今有相当数量未被检测出患有高血压或高血压未得到控制的患者正在寻求牙科治疗。这些患者面临中风、心脏病、肾病和视网膜疾病等严重并发症的高风险。血压极高的患者在接受牙科治疗时极易出现急性医疗问题。出于这些原因，牙科必须继续重视高血压患者的检测和转诊。此外，越来越多有医学问题的患者正在寻求牙科治疗，在进行诸如口腔外科手术、牙周手术和种植牙植入等压力较大的牙科手术过程中，应对他们的血压进行监测。本文综述了高血压在牙科和医学管理方面的最新进展。对于牙医而言，了解与牙科诊疗相关的高血压情况非常重要。
