Interdisciplinary Management of White Coat Hypertension in Geriatric Oral Surgery: Case Report

老年口腔外科白大衣高血压的跨学科管理:病例报告

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Abstract

INTRODUCTION: White coat hypertension in geriatric patients can complicate dental procedures in the presence of intense anxiety. OBJECTIVE: To evaluate the effectiveness of a combined approach of psychological intervention and sedation for the control of the syndrome during multiple extractions. CASE PRESENTATION: A 76-year-old woman with a diagnosis of white coat hypertension (WCH) and a history of dental anxiety. In two previous attempts, the surgery was suspended due to blood pressure elevation. The Dental Perception Reprogramming Protocol (DPRP) was applied along with conscious sedation (midazolam, fentanyl, dexmedetomidine) which allowed agitation, so deep sedation with propofol was used. RESULT: The patient had stable blood pressure (119/82 mmHg) and successfully completed the intervention without complications. CONCLUSIONS: The integration of psycho-behavioral and pharmacological techniques allowed effective hemodynamic control, and a key interdisciplinary approach is suggested for the management of the syndrome in older adults.

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