MANAGEMENT OF PATIENTS WITH HYPERTENSIVE PEAK IN DENTISTRY: LITERATURE REVIEW

Abstract

Systemic arterial hypertension (SAH), a highly prevalent condition in the population, can manifest as uncontrolled spikes in blood pressure, representing a significant complication during dental procedures. The dental clinical environment, due to its potentially stressful nature, associated with factors such as anxiety and pain, represents a trigger for critical blood pressure elevations. The objective of this study is to conduct a literature review on management strategies for patients experiencing hypertensive spikes in the dental office, with emphasis on immediate intervention and evidence-based protocols. A literature review was conducted through a systematic search of the PubMed, SciELO, LILACS, Ebsco, Google Scholar, Embase, and Scopus databases, covering the period from 2010 to 2025. Eighteen original and review articles in Portuguese, English, and Spanish were included, specifically addressing the etiology, risk factors, diagnosis, and management related to hypertensive spikes during dental care. The review highlighted that blood pressure measurement and a detailed medical history are essential for prevention and risk assessment. Managing a hypertensive crisis involves interrupting the procedure, repositioning the patient, offering emotional support, and, if necessary, using fast-acting antihypertensives such as captopril or nifedipine. Differentiating between urgency (in-office management) and emergency (immediate referral) is crucial. Continuous training in basic life support and the judicious use of vasoconstrictors are also fundamental for patient safety. It is concluded that the safe management of patients with hypertensive crises in dentistry depends on the adoption of systematic protocols, encompassing everything from prevention to crisis management. Ongoing education and integration with the patient's systemic health are essential for evidence-based and safe clinical practice.