Dentaltown August 2021 - 22

message board
BP Is Serious Stuff
Docs highlight stories-some fatal-of patients with blood pressure problems
and highlight the importance of checking those who enter each operatory
Chmrb
Member Since: 02/25/17
Post: 1 of 66
I saw a walk-in patient last October (2020) who was referred by the local ER. He had gone
there in the early hours of the morning due to pain/swelling of the LL jaw. They gave him
antibiotic injections, a round of Augmentin, and told him to see a dentist. I diagnosed him
with AAA of 19 and recommended extraction. However, his BP was 200+/100+ on multiple BP
readings. I called my local OS to see if there was anything I could do, and he told me that the
patient simply needed to see a doctor about getting his BP under control.
I really wanted to help this patient, but not even the OS would touch him with such high BP.
I referred the patient to a doctor for treatment of his HTN and instructed him to go to the ER
if he experienced any increased swelling, diffi culty breathing/swallowing, or any uncontrolled
pain. I gave him a referral letter to take to a physician.
On March 2021 this patient reappeared with similar symptoms as his fi rst visit and I again
recommended taking out 19. He hadn't been to a doctor and so his BP was still 200+/110+. I
again informed the patient he would have to get his BP under control before I could remove the
tooth. I prescribed antibiotics and gave him a second referral letter to take to a physician.
Today this patient's wife came to my offi ce and asked for a letter explaining that the patient
had come to my offi ce twice and that his BP was too high to do treatment. The patient had a
brain aneurysm in early April and is now in a rehab facility recovering from the effects of the
aneurysm. This rehab facility had requested the letter from me.
1. BP is serious stuff.
2. I'm glad I didn't do any treatment. Never do when BP is high. Never will either. (I
absolutely refuse to treat anyone with BP 180+/110+, period. Ever.) Any patient I see with
BP 180+/110+ gets a referral letter. Some go and some don't.
3. Never cave to patients who pressure you to work on them when their BP is high. They will
tell you their BP has been high for years and that it never bothers them and that they've
never had any problems because of it. They'll tell you another doc took out a tooth even
though their BP was high and there weren't any problems. They'll give you a sob story
about how they have to get back to work or they won't be able to make rent for the month.
They will do everything you can to make you feel guilty for refusing to treat them. Don't
give in.
4. Document everything. I have thorough notes from each visit and copies of the discharge
notes from the ER he brought and also copies of both referral letters I gave him.
5. l can't imagine the position I would be in had I removed the tooth and the guy had an
aneurysm in my chair. BP is serious stuff. ■
5/27/2021
22 AUGUST 2021 // dentaltown.com
https://www.dentaltown.com/messageboard/thread.aspx?s=2&f=173&t=356334&g=1 http://www.dentaltown.com

Dentaltown August 2021

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