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What Is Hypertension?
Hypertension is the term used to describe high blood pressure (Medline Plus 2011).
In today’s society, high blood pressure is the most common problem managed by general practitioners. The prevalence of hypertension indicates that 3.7 million Australians over the age of 25 have high blood pressure, or are on medication for the condition, which is 32% of men and 27% of women (AIHW 2011). One third of individuals affected by the disease are unaware of its presence, hence why hypertension is referred to as the ‘silent killer’ due to its asymptomatic manner (Little 1997).
What is Blood Pressure?
Blood pressure is a measurement of the force against the walls of the arteries as the heart contracts and pumps blood around the body (Tortora & Derrickson 2009). Blood pressure readings are given as two measurements; systolic and diastolic pressure. Systolic pressure corresponds to the pressure in the arteries when the heart contracts and pumps blood forward into the arteries. Diastolic pressure represents the pressure in the arteries as the heart relaxes after contracting and as it fills up with blood again (MedicineNet.com 2011).
Symptoms of Hypertension
For most individuals there are no symptoms of hypertension and most cases are found out when visiting a health care provider. Due to there being no symptoms, most patients will not know they have high blood pressure and can develop heart disease and kidney problems without knowing so straight away (Medline Plus 2011).
Patients with severe hypertension, known as ‘Malignant Hypertension’ can often experience:
– Severe headaches
– Changes in vision
– Chest Pains (PubMed Health 2011 & AIHW 2011).
Effects on Oral Health
Often medications that are used to treat hypertension (anti-hypertensive medications) can have effects on the oral environment. Some may cause patients to experience dry mouth, also known as Xerostomia (Colgate 2011). Xerostomia may result in gingivitis, periodontal disease or due to erosion, loss of tooth structure (Bartels C, 2000). Overtime if left untreated, Xerostomia will lower the pH within the oral cavity, which will increase the development of plaque and therefor dental caries (Bartels C, 2000).
An altered sense of taste (Dysgeusia) is another effect hypertension medications may have on the oral cavity as well as some others may make patients more likely to faint when raised in a dental chair too quickly, which is a reaction known as Orthostatic Hypotension (Colgate 2011).
Gingival overgrowth (Gingival Hyperplasia) is another possible side-effect of medications used to treat high blood pressure, for example, Calcium channel blockers can often have this effect (Colgate 2011). Some patients will have to undergo gingival surgery to remove some of the gingiva, but quite often it will just grow back. The gingiva are very difficult to look after when experiencing this overgrowth, as plaque can easily get trapped underneath and as they are often quite sore, it is difficult to brush and therefore maintain good oral health (Colgate 2011).
Example of drymouth (Xerostomia):
Examples of gingival hyperplasia:
At the Dentist
Patients with high blood pressure should have their dentist check their blood pressure at each visit. Depending on how high the blood pressure is, how well it is controlled and whether the patient has any other medical conditions, the dentist can decide whether or not it is safe for non-emergency treatment to be completed (Colgate 2011).
Most people suffering from hypertension can safely take anti-anxiety medications, such as Nitrous Oxide or Valium, and can also safely receive local anaesthetics for dental procedures. It is extremely important that dental professionals know which medications a patient with hypertension is on at every dental visit (Colgate 2011).
A Stroke is the result of the blood supply to the brain being disrupted. The arteries carrying blood to the brain may become blocked by plaque or a blood clot or they may rupture (Stroke Foundation, 2007). Stroke is one of the top three causes of death worldwide with more than 700,000 Americans and 40,000 Australians suffering from one each year and more than 150,000 passing away as a result (Libby, P et.al, 2008 & Brain Foundation, 2011). There are a higher proportion of women who suffer from Stroke compared to only 40% of whom are men and this disease mainly affects minority groups (Libby, P et.al, 2008).
There are two main ways that a Stroke can occur.
Ischaemic stroke (blocked artery)
The most common form of Stroke is known as an Ischaemic Stroke (Brain Foundation, 2011). This occurs from a blockage in the artery that is carrying blood to part of the brain. Blockages can occur in two ways; either by a blot cot that has formed somewhere else in the body that travels to the brain where it is too large to pass through the arteries, this is known as Embolic Stroke or by Thrombotic Stroke which is caused by build-up of cholesterol ‘plaque’ that narrows the size of the artery (Stroke Foundation, 2007). If blood supply to any part of the brain ceases for more than a few minutes, that specific part of the brain stops functioning and brain tissue begins to die. (Brain Foundation, 2011). As a result, if the blockage is not cleared, the whole part of the brain that the particular artery supplies, may die. This is often called brain infarction (Brain Foundation, 2011).
Haemorrhagic stroke (bleed in the brain)
Also known as cerebral haemorrhage, this kind of Stroke occurs a result of a blood vessel rupturing within the brain or into the space around the brain (Brain Foundation, 2011). Due to the high pressure inside the artery, as it bursts, it also tears the brain tissue, resulting in a large clot that ultimately puts pressure on the brain and can cause brain death. (Brain Foundation, 2011).
Symptoms of Stroke
Everyone is affected differently; however symptoms of stroke usually come on very suddenly. (Brain Foundation, 2011). Common warning signs include sudden numbness of the face, arm or leg on one side of the body, dizziness , loss of balance, confusion, trouble communicating and walking, blurred vision and headaches (Brain Foundation, 2011 & Stroke Association, 2011). Some people affected my symptoms such as nausea, vomiting, drowsiness or seizures, although such symptoms are rarer (Brain Foundation, 2011).
In 2006, a campaign to increase awareness of the common warning signs of Stroke was established to help prevent delayed reaction and improve the outcomes of sufferers (Stroke Foundation, 2011). This is known as FAST, referring to the face, the arms, speech and time (Stroke Foundation, 2011). This campaign aims to teach people in the general community to act fast if they witness signs and symptoms such as, a drooped face, inability to lift arms and or slurred speech (Stroke Foundation, 2011).
Effects on Oral Health
The after effects of a Stroke can be both challenging and demanding for patients in regards to the whole body but in particular, the health and maintenance of the oral cavity.
One of the general health effects of a Stroke is paralysis on one side of the body (Colgate, 2011). Paralysis is defined as being “an impairment or loss of the motor function of the nerves, causing immobility” (Anderson J, 2007, pg. 762). Such impairment could lead to a number of issues including, not being able to brush the teeth efficiently on the effected side, difficulties with rinsing of the mouth and not realising when food is left in the oral cavity (Colgate, 2011). If not monitored, this could ultimately lead to caries, gingivitis and or periodontal disease; however there are options available such as electric toothbrushes, floss holders and large interdental brushes to prevent such outcomes.
Certain medications that are prescribed to Stroke victims can lead to a dry mouth, known as Xerostomia (Brady, M et.al, 2007). Side effects include a constant sore throat, difficulty communicating, impaired swallowing and dry nasal passages (Bartels C, 2000). Three out of ten patients with Xerostomia will result in gingivitis, periodontal disease or loss of tooth structure by erosion (Bartels C, 2000). If left untreated, Xerostomia will lower the pH within the mouth and increase the development of plaque and therefore dental caries (Bartels C, 2000). Treatment options include saliva substitutes such as GC Dry Mouth Gel or certain types of tablets that increase the quantity of saliva. Blood thinning medications can effect certain dental procedures including extractions and deep scaling (Colgate, 2011). Such medications may need to be stopped prior to these types of treatments and it is therefore vital that Stroke victims give oral health care providers up to date and accurate medical histories.
Another oral health effect of Stroke is ulcers of the mouth (Brady, M et.al, 2007). Although most ulcers are harmless and clear up by themselves, there can be a number of complications is left untreated including bacterial infection, inflammation of the mouth (cellulitis) or development of an abscess.
Denture Stomatitis is s fungal/yeast disease that leads to infection in the mouth (Better Health Victorian Government, 2011). The wearing of dentures may be compromised as a result of a Stroke and many dentures need to be adjusted in such circumstances (Colgate, 2011 & (Brady, M et.al, 2007). Denture Stomatitis can be caused by inadequately cleaned or ill-fitting dentures and such disease may need medication to rectify.
Sporting accidents are one of the most common causes of dental injury. Every year thousands of people, including young children, are treated for dental injuries that could have been prevented or at least minimised by wearing a custom-fitted mouthguard.
It doesn’t matter what type of sport you are playing, you should always wear a protective mouth guard, even during training sessions.
With the upcoming football and netball seasons fastly approaching, now is the time to get your mouth guard. All it takes is one simple appointment where a mould is taken of your upper teeth. This mould is then sent to a specialist laboratory where a custom fitted mouth guard is made in a colour of your choice.
If you already have a mouth guard, we recommend that you have it assessed every 12 months by your dentist to ensure that it has optimal fit and protection.
Mouth guards should be stored in a rigid container and kept away from heat. Ensure your mouth guard is rinsed after each use and stored correctly to improve its longevity.
So why spend the money on a custom fitted mouth guard when you can get one cheaper over the counter at a chemist you may be asking. Over-the-counter mouthguards provide inadequate protection against dental injuries, and the potentially significant costs associated with dental injuries means investing in a custom-fitted mouthguard is worthwhile.
For more information please visit the website below or to make an appointment call Clare Dental on 08 8842 29999
Using fluoride toothpaste twice a day is very effective at reducing tooth decay
Teach children to spit the toothpaste so they don’t swallow and ingest too much fluoride
Don’t rinse! Keep the fluoride on your teeth after brushing
Do not use fluoride toothpaste on children under the age of 18 months.