Blood Pressure in the Dental Chair

Blood Pressure in the Dental Chair

When to treat, refer, or cancel according to dentists


Most U.S. dentists agree BP screening is a good risk management tool, especially before anesthesia, extractions, or sedation, but there’s wide variability in whether and when it’s actually done. Some never take BP (especially in older NY practices), while others do it for every patient, every visit. International dentists (UK, Germany, Norway) often see BP screening as excessive, driven by U.S. malpractice fears.

Many posters cite 160/100 as a reasonable cutoff for routine dental procedures. Some use 180/110 as a hard stop unless it’s an emergency. The “300 rule” (systolic + diastolic ≥ 300) is mentioned, but it’s not a formal guideline. Several dentists shared stories of detecting dangerous hypertension during routine visits and potentially saving lives. Others argue most procedures are safe even at moderately elevated BP and worry about alienating patients or derailing care over isolated high readings, especially if the patient is anxious or says it’s “always high.”

The ADA and JADA 2020 are frequently referenced. JADA questioned rigid BP cutoffs and advised a more functional, individualized approach. The AHA distinguishes hypertensive urgency (≥180/120 without symptoms) from emergency (with symptoms), recommending calling 911 only in the latter.

Liability concerns are a major theme. U.S. dentists emphasize documenting vitals and explaining deferred care when BP is high, especially since poor documentation has led to legal trouble. Many stress that once you take BP and it’s dangerously high, you can’t “unknow” it. The safest course is to delay treatment, advise medical follow-up, and chart everything.

The overall consensus: take BP when anesthesia is planned, when patients have known hypertension, or when clinical judgment suggests it, if only to cover yourself. Some clinicians treat slightly hypertensive patients with stress-reduction protocols or local anesthetics without epinephrine. Still, when in doubt, delay care and document clearly.


Join the Conversation!


Sponsors
Townie Perks
Townie® Poll
Who or what do you turn to for most financial advice regarding your practice?
  
Sally Gross, Member Services Specialist
Phone: +1-480-445-9710
Email: sally@farranmedia.com
©2025 Dentaltown, a division of Farran Media • All Rights Reserved
9633 S. 48th Street Suite 200 • Phoenix, AZ 85044 • Phone:+1-480-598-0001 • Fax:+1-480-598-3450