Authors’ response – The Journal of the American Dental Association

We greatly appreciate Dr. Bavitz’s kind words and his interest in hypertension in
dentistry for over 20 years. We completely agree that encouraging dentists to obtain
accurate blood pressure (BP) measurements will educate patients about the importance
of hypertension while contributing to diagnosing new office hypertension in patients
that may not have access to BP measurements. We also appreciate his support in using
a simple functional capacity assessment concurrently with BP measurement for especially
complex dental procedures, rather than simply canceling the procedure due to elevated
office BP measurements. We agree that a multicenter randomized trial would be useful,
but likely not practical, owing to the cost. We would suggest that for complex elective
dental procedures that patient should correctly measure home BP twice daily, when
awakening and at bedtime the week before the procedure. This would importantly assess
hypertension control and if it is elevated in office before the procedure, while normal
at home, then white-coat anxiety would be the source of elevation and easily treated
by sedation.

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