Changes in mean heart rate and mean systolic and diastolic blood press
ure are induced by both the patient's anticipation of scheduled treatm
ent and the actual dental treatment itself. Significant changes have b
een observed before application of a local anesthetic, during restorat
ive treatment, during extractions, and when epinephrine-impregnated re
traction cords were used. These cardiovascular responses may vary acco
rding to the local anesthetic used and the choice of vasoconstrictor.
The individual changes in heart rate and blood pressure are affected b
y pain and such individual factors as age, gender, hypertension, denta
l experience, and psychological responses. Although for the most part
the cardiovascular changes induced by dental treatment are limited and
within the normal physiological variation, this review stresses the i
mportance of eliminating pain and minimizing patient anxiety.