Maybe you feel the signs: a flutter in the belly or a quickening of your heart. Although it is normal to feel a little anxiety at your doctor or dentist’s office, white coat hypertension is a condition that can affect your willingness to go for treatment (and may be a sign of something more serious). Here’s what you need to know.

What is white coat hypertension?

White coat hypertension is related to high blood pressure (hypertension). An average and healthy blood pressure reading is anything 120/80 millimeters of mercury (mmHg) or below. Hypertension is the medical name for blood pressure that is above 140/90 (mmHg). An estimated 32% of people in the U.S. have high blood pressure.

White coat hypertension – an elevated blood pressure reading – is a blood pressure spike that occurs only when you enter a doctor’s office. For people with dental anxiety ranging from mild to severe – an estimated 60% of us report it – white coat hypertension can be a roadblock to regular dental care.

What causes white coat hypertension?

A primary cause of this condition may, in fact, be hypertension that occurs outside of the doctor’s office.

The journal Hypertension found that between 15 and 30% of people with high blood pressure at the doctor’s office might be affected by hypertension outside of it. People who already have hypertension, even controlled hypertension, are more likely to experience a spike in the presence of a white lab coat.

The stress and anxiety of a visit to the dentist may cause white coat hypertension, but not all researchers agree that anxiety is the foundational cause. A study in the Journal of the American College of Cardiology found that people who had white coat hypertension also had cardiovascular issues, some of which were undiagnosed until they experienced white coat hypertension.

Risk factors for hypertension

The precise cause of hypertension is unknown, but some factors that may contribute to it include:

  • Obesity
  • Inactivity
  • Smoking and drinking
  • High-salt diet
  • Genetic history of hypertension
  • Kidney disease
  • Excessive amounts of prolonged stress
  • Sleep disorders, like sleep apnea

Additionally, people who experience white coat hypertension have an increased risk of stroke. Whether the white coat hypertension comes before the risk of stroke and cardiovascular issues or after is hard to say, but the connection is clear.

White coat hypertension symptoms

High blood pressure is referred to as a “silent killer” because many people are unaware that they have it. In the case of white coat hypertension, you may experience symptoms when you step into the dentist’s (or doctor’s) office.

White coat hypertension symptoms include:

  • Headache
  • Fatigue
  • Chest pain
  • Difficulty breathing
  • Pounding in the head, chest, or ears
  • Ringing in the ears

For many, these symptoms are similar to symptoms they might experience during an anxiety attack or if they are feeling panicked. They are also symptoms that are similar to PTSD.

While these are not technically symptoms of white coat hypertension, these can occur in conjunction with hypertension. This may alert patient and doctor to the presence of elevated blood pressure.

It can be tempting to write this condition off as an occasional nuisance that can be ignored, but don’t give in to that temptation. These instances of white coat hypertension can actually be a sign that you are vulnerable to hypertension. Leaving that untreated can lead to more serious diseases as noted above.

How do you get rid of white coat hypertension?

Patients who experience white coat hypertension only when they enter their dentist’s office may be also suffering from mild to severe dental anxiety or phobia. It is possible, though, to begin white coat hypertension treatment before you even enter your dentist’s office.

Start with lifestyle changes

First, make changes to your lifestyle that can benefit your blood pressure. If you are carrying extra weight and lead a generally sedentary lifestyle, incorporating regular walks (especially in nature) into your day can help shed weight and lower blood pressure.

Changing your diet to include lower-salt options can also help manage your blood pressure. Quitting smoking and reducing the amount of alcohol you consume are also positive steps you can take for your overall health and wellness.

Work with a dentist you trust

Next, look for a compassionate dentist who has the patience and experience necessary to work with patients who experience anxiety.

They need to be willing to:

  • Take frequent breaks during procedures
  • Explain everything thoroughly (sometimes more than once)
  • Stop if you become overwhelmed

Your dentist should also be willing to break treatments up if necessary to make them less intense. They can also shorten the duration of each visit.

Also see if your dentist offers pain-free sedation dentistry and laser dentistry. Knowing that you have options for less painful procedures can help calm fears you have before you schedule your first appointment.

Use relaxation techniques

Once in the office, use the following techniques to help reduce white coat hypertension:

  • Deep breathing and meditation: Mindfulness meditation and deep breathing practices are proven to lower blood pressure and can calm the central nervous system’s flight response
  • Bring a friend for support: Sometimes having someone you trust in the room with you can help with white coat hypertension by supporting you (or distracting you)
  • Bring your own distractions: If your friend isn’t distracting enough, listen to your favorite music or listen to a funny podcast on your phone

For patients with severe white coat hypertension, it is important to identify any potential health issues that may be contributing to it. If you have severe white coat hypertension but receive a clean bill of health otherwise, you may be able to get relief by working through your fears or anxiety with a trained therapist.

AZ Dentist is the dentist for nervous patients in the Phoenix area, with a warm and welcoming office staff and gentle, compassionate dentists. Get in touch today to experience the AZ Dentist difference.

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