Hypertension, whether uncontrolled or managed well with medications, should be an important consideration in the treatment planning of any major tooth implant procedure. Dental implants are placed in the bone and do not have any effect on blood pressure, nor does the blood pressure have any effect on bone integration. However, blood pressure and medications taken to manage them can create harmful situations for patients who have not properly addressed their condition with their treating dentists.
Discussing High Blood Pressure & Medications With Your Dentist
A blood pressure reading is a measurement of how hard the body is working to push the blood out of the heart, through the body, and back into the heart. When more effort is required to circulate the blood the circulation is much less effective and less able to withstand increased heart activity during periods of anxiety. Very high blood pressure during a dental procedure involves a significant risk of stroke or kidney damage. Patients who take blood pressure medications to manage their hypertension are perfectly safe as long as they do not experience high levels of anxiety during their procedure. For this reason, pain management is critical in the implementation of planned tooth implant procedures.
Medications should be taken to keep the blood pressure under control and analgesics should be delivered to manage pain and resulting anxiety but the combination of the two can actually cause the biggest issue for hypertensive patients undergoing dental implant procedures. The biggest mistake a hypertensive patient can make is failing to tell their dentist about the medications they are taking to control their blood pressure. Local anesthesia drugs such as epinephrine have more intense effects on the heart when combined with nonselective beta-blockers and can result in rapid increases to blood pressure which is exactly what the anesthesia was supposed to help avoid—pain, anxiety, and resulting higher blood pressure. The best way to effectively reduce pain and anxiety without aggravating the heart with a combination of medications is to deliver an adequate dosage of numbing agents spread out over more injections over a greater length of time. Though it may seem like the best way to limit the stress on the heart is to get the patient through the procedure quickly and allow them to begin to relax sooner, that just isn’t the case.
Post Operative Dental Implant Care For Patients With High Blood Pressure
After the dental implant procedure there are also considerations for the post-operative recovery and healing period. Unmanaged high blood pressure limits the delivery of oxygen and nutrients to the veins and capillaries, which lowers their ability to regenerate and heal cells. Extended time with open wounds in the mouth increases risk of infection, swelling, and entry of harmful bacteria into the bloodstream.
Blood pressure managed by medication has very little impact on the progress of healing after tooth implant placement but still needs to be discussed between dentist and patient. Most dental implant procedures have an impressively quick recovery period and patients are able to resume normal activities without pain management within a few days. For those who need to take medication for discomfort for extended periods of time, they are at risk of decreased effectiveness with drug interactions. NSAIDS like Ibuprofen work against beta-blockers, alpha-blockers, vasodilators, ACE inhibitors, and diuretics when taken long enough. Again, this is most typically not a concern for a dental implant patient.
The bigger concern following tooth implant procedures is gum health and oral hygiene. Calcium channel blockers often cause the gums to become slightly swollen and overgrown which makes it more difficult to keep them clean. While implants and implant supported dentures are immune to cavities and gum disease, gum irritation can still be harmful and should be avoided to protect the integrity of the dental implant treatment.
The best way to prepare for your dental implant procedure is to tell your dentist if you have high blood pressure or are keeping your blood pressure under control with medications. Your dentist will know how to keep you safe and comfortable during your procedure and educate you on proper care of your implants after your smile is restored.