The effect of body mass index on blood pressure and heart rate in patients undergoing tooth extraction

Document Type: Original Article

Authors

1 Assistant Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Van Yuzuncu Yil University, Van, Turkey

2 Department of Oral and Maxillofacial Surgery, Tekirdag Oral and Dental Health Hospital, Tekirdag, Turkey

Abstract

BACKGROUND AND AIM: Alterations in blood pressure (BP) and variability of heart rate (HR) throughout dental procedures were not clearly understood. The aim of this study is to evaluate the effects of body mass index (BMI) on BP and HR in patients undergoing tooth extraction.
METHODS: Based on BMI, 831 patients who underwent single tooth extraction were divided into two groups; group 1: underweight and normal-weight patients, group 2: overweight and obese patients. BP and HR were monitored before local anesthesia and after tooth extraction. For statistical analysis of the data, Number Cruncher Statistical System (NCSS) 2007 program was used. Mann-Whitney U test and Student’s t-test was used for comparing the differences between groups.
RESULTS: The initial and final BP measurements of overweight and obese patients were found to be significantly higher than underweight and normal-weight patients (P < 0.01). There was no statistically significant difference between groups in terms of initial and final HR measurements (P > 0.05).
CONCLUSION: Overweight and obese patients are more likely to have increased BP; therefore, monitoring of BP and HR during tooth extraction is crucial in this group of patients to prevent possible complications.

Keywords


  1. Cigerim L. Medical profile of individuals who apply to faculty of dentistry. Van Med J 2019; 26(1): 1-5.
  2. Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison HC, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018; 71(19): e127-e248.
  3. Abu-Mostafa N, Aldawssary A, Assari A, Alnujaidy S, Almutlaq A. A prospective randomized clinical trial compared the effect of various types of local anesthetics cartridges on hypertensive patients during dental extraction. J Clin Exp Dent 2015; 7(1): e84-e88.
  4. Holm SW, Cunningham LL, Bensadoun E, Madsen MJ. Hypertension: Classification, pathophysiology, and management during outpatient sedation and local anesthesia. J Oral Maxillofac Surg 2006; 64(1): 111-21.
  5. Cook S, Togni M, Schaub MC, Wenaweser P, Hess OM. High heart rate: A cardiovascular risk factor? Eur Heart J 2006; 27(20): 2387-93.
  6. Fatisson J, Oswald V, Lalonde F. Influence diagram of physiological and environmental factors affecting heart rate variability: An extended literature overview. Heart Int 2016; 11(1): e32-e40.
  7. Gortzak RA, Oosting J, Abraham-Inpijn L. Blood pressure response to routine restorative dental treatment with and without local anesthesia. Continuous noninvasive blood pressure registration with a finger manometer. Oral Surg Oral Med Oral Pathol 1992; 73(6): 677-81.
  8. Cheraskin E, Prasertsuntarasai T. Use of epinephrine with local anesthesia in hypertensive patients I. Blood pressure and pulse rate observations in the waiting room. J Am Dent Assoc 1957; 55(6): 761-74.
  9. Ezmek B, Arslan A, Delilbasi C, Sencift K. Comparison of hemodynamic effects of lidocaine, prilocaine and mepivacaine solutions without vasoconstrictor in hypertensive patients. J Appl Oral Sci 2010; 18(4): 354-9.
  10. Faraco FN, Armonia PL, Simone JL, Tortamano N. Assessment of cardiovascular parameters during dental procedures under the effect of benzodiazepines: A double blind study. Braz Dent J 2003; 14(3): 215-9.
  11. Matthews KA, Woodall KL, Allen MT. Cardiovascular reactivity to stress predicts future blood pressure status. Hypertension 1993; 22(4): 479-85.
  12. Dua S, Bhuker M, Sharma P, Dhall M, Kapoor S. Body mass index relates to blood pressure among adults. N Am J Med Sci 2014; 6(2): 89-95.
  13. Cordeiro MG. Maciel AD, Pedro FL, Bandeca TC, Borges AH, Maciel FJ. Blood pressure variation in patients undergoing tooth extraction. Sci J Dent 2015; 2: 8-12.
  14. Cui QY, Chen SY, Fu S, Zhang CB, Li M. Survey and analysis of tooth extraction anxiety of dental patients. Hua Xi Kou Qiang Yi Xue Za Zhi 2018; 36(3): 314-8. [In Chinese].
  15. Marciani RD, Raezer BF, Marciani HL. Obesity and the practice of oral and maxillofacial surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 98(1): 10-5.
  16. Abraham-Inpijn L, Borgmeijer-Hoelen A, Gortzak RA. Changes in blood pressure, heart rate, and electrocardiogram during dental treatment with use of local anesthesia. J Am Dent Assoc 1988; 116(4): 531-6.
  17. Silvestre FJ, Verdu MJ, Sanchis JM, Grau D, Penarrocha M. Effects of vasoconstrictors in dentistry upon systolic and diastolic arterial pressure. Med Oral 2001; 6(1): 57-63.
  18. Gungormus M, Buyukkurt MC. The evaluation of the changes in blood pressure and pulse rate of hypertensive patients during tooth extraction. Acta Med Austriaca 2003; 30(5): 127-9.
  19. Vanderheyden PJ, Williams RA, Sims TN. Assessment of ST segment depression in patients with cardiac disease after local anesthesia. J Am Dent Assoc 1989; 119(3): 407-12.
  20. Chaudhry S, Iqbal HA, Izhar F, Mirza KM, Khan NF, Yasmeen R, et al. Effect on blood pressure and pulse rate after administration of an epinephrine containing dental local anaesthetic in hypertensive patients. J Pak Med Assoc 2011; 61(11): 1088-91.
  21. Lopez-Jornet P, Camacho-Alonso F, Sanchez-Siles M. Assessment of general pre and postoperative anxiety in patients undergoing tooth extraction: A prospective study. Br J Oral Maxillofac Surg 2014; 52(1): 18-23.
  22. Haas DA. An update on local anesthetics in dentistry. J Can Dent Assoc 2002; 68(9): 546-51.