Cardiovascular responses in patients and dentists during dental treatment

Changes in mean heart rate and in mean systolic and diastolic blood pressur e are induced by both the patient's anticipation of scheduled treatment and the actual dental treatment. Most of these changes are within the normal p hysiological variations, but significant changes are observed before admini stration of a local anaesthetic, during subgingival debridement and during extractions. Individual changes in heart rate and blood pressure are affect ed by age, gender, hypertension and previous dental experience. Pain also p lays an important role in the cardiovascular response during dental treatme nt, which stresses the need for adequate analgesia. For this purpose, local anaesthetics with low concentrations of epinephrine seem preferable. They induce less pronounced cardiovascular responses than local anaesthetics wit h higher concentrations of epinephrine or without epinephrine. The changes in heart rate and blood pressure that occur in the dentist during the treat ment are also discussed.