Systemic diseases in elderly dental patients.

Systemic diseases, blood pressure and pulse rate, were investigated in 1012 elderly patients who consulted the gerodontic clinic of Tokyo Medical and Dental University Hospital. One or more systemic diseases was found in 64.2 per cent of the subjects. Hypertension was the most frequent systemic disease, occurring in 30.9 per cent of the subjects, and was followed by angina pectoris, diabetes, arrhythmias, digestive diseases, cerebrovascular diseases and myocardial infarction, respectively. Nearly 17 per cent of the patients had two or more diseases. Among these diseases, hypertension was frequently combined with angina pectoris, myocardial infarction, arrhythmia, and cerebrovascular diseases. Patients with systemic diseases are at a greater risk during dental treatment. Psychosomatic stress and vasoconstrictors in local anaesthesia possibly induce the exacerbation of systemic diseases or unexpected cardiovascular reactions. Isolated systolic hypertension (systolic blood pressure of 160 mm Hg or more) was noted in 14.3 per cent of the patients. Among these patients, 6.3 per cent of patients were hypertensive patients who had both above 160 mm Hg systolic pressure and 95 mm Hg diastolic pressure. Elderly dental patients have various systemic diseases. Accordingly, it is very important for the dentist to identify systemic diseases of patients and to understand systemic conditions before treatment commences.