Investigation Of Dental Anxiety And The Effect Of Intervention On Blood Pressure And Heart Rate In Elderly Patients With Hypertension

Objective: To analyze the incidence of dental anxiety and its related factors in elderly patients with hypertension before tooth extraction,and to compare the effect of different intervention measures on blood pressure and heart rate in the process of tooth extraction in elderly patients with hypertension,so as to provide a basis for improving the safety of tooth extraction in elderly patients with hypertension.Methods: From March 2018 to May 2019,800 elderly patients with hypertension underwent tooth extraction surgery in the outpatient department of oral surgery of Shanghai Ninth People’s Hospital affiliated to Shanghai Jiao Tong University School of Medicine were selected by simple random sampling.Corah’s Dental Anxiety Scale(DAS)was used to evaluate the anxiety level of patients,and the possible related factors of anxiety were investigated by questionnaire.During dental treatment,patients’ blood pressure and heart rate were monitored,and the influence of anxiety level on blood pressure and heart rate was analyzed.63 patients with obvious dental anxiety were randomly divided into three groups: psychological intervention group,drug intervention group and blank control group.Different preoperative intervention measures were taken to compare the intraoperative blood pressure and heart rate of patients in the three groups.Results: 9.5% elderly patients with hypertension had obvious dental anxiety(DAS score≥13).Scores were significantly higher in these types of patients: female,who had a painful experience with tooth extraction,who was self-conscious oral unhealthy,who was unclear about the tooth extraction process,who was emotional,with poor pain tolerance,and accompanied by friends and family.The differences in systolic blood pressure,diastolic blood pressure and heart rate were statistically significant before tooth extraction,after anesthesia and after tooth extraction(P < 0.01),and the higher the anxiety level was,the higher the systolic blood pressure and diastolic blood pressure were.The patients’ DAS score was positively correlated with the increase of systolic blood pressure(b=0.539,P <0.01).Psychological intervention or drug intervention before tooth extraction in patients with significant dental anxiety significantly reduced the increase in intraoperative systolic blood pressure(P <0.01).Conclusion: The incidence of anxiety disorder in the department of dental extraction in elderly patients with hypertension is not low,and the relevant factors of anxiety should be fully evaluated before tooth extraction.During the tooth extraction process,the blood pressure and heart rate of elderly patients with hypertension increased with the increase of dental anxiety level,and the blood pressure and heart rate were the highest after anesthesia.For patients with obvious dental anxiety,adequate psychological counseling or drug treatment before surgery can effectively relieve patients’ anxiety,reduce blood pressure fluctuations,and improve the safety of clinical tooth extraction.