This research proposal aims to determine if registered dental hygienists in Connecticut are taking blood pressure screenings on patients during dental hygiene visits. A survey of 10 questions will be distributed to dental hygienists to gather data on current screening practices and any barriers. The significance is that screenings allow for early detection of hypertension and prevention of medical emergencies. Results will show how many dental offices emphasize screenings and whether hygienists are following their full scope of practice. Descriptive statistics will analyze responses to determine if hygienists are properly screening patients by taking blood pressure readings at each appointment.

1. Research Proposal
Blood Pressure Screenings at Dental
Hygiene Visits
________________________________________________________________
April 29th
, 2015
Bethany Bates
Amanda Milardo
Marlene Casenova
Oriana Rodriguez

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Chapter 1 - Introduction
Problem:
This study will determine if registered dental hygienists are taking blood
pressure on patients at dental hygiene visits to provide comprehensive patient
care.
Significance of the problem:
Routine blood pressure and vitals screening are an important factor to a person’s
overall health. To provide comprehensive patient care at dental hygiene
appointments, vitals should be taken as a screening precaution and to avoid
medical emergencies. The American Heart Association suggests that 33% of
U.S. adults over the age of 20 have hypertension (Heart Disease, 2014). Dental
hygienists should complete essential screenings to prevent medical emergencies
and provide early disease detection.
This study will determine the quantity of dental hygienists that are providing blood
pressure screenings for detection of hypertension. This holds great significance
because it allows us to find out how many dental offices emphasize the
importance of blood pressure screenings. Furthermore, determining how many
dental hygienists are following through with the duties outlined in the dental
hygiene scope of practice. Our results will determine the amount of dental
hygienists that are performing these screenings, and if not, what is restraining
them.

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Terms:
Blood pressure stages: normal (systolic less than 120 diastolic less than 80),
pre-hypertension (systolic 12-139 and diastolic 80-89) and hypertension (systolic
140 or higher and diastolic 100 and higher).
Pulse: (60-100 beats per minute) and respiration (12-20 beats per minute)
Prevention: Preventing the progression of hypertension and/or cardiovascular
disease, as well as preventing medical emergencies in dental settings is also part
of the dental hygienist’s job.
Early detection: Detection of disease before progression. Early detection of
hypertension is key to maintaining optimum systemic and oral health. Many
patients don’t have diagnosed hypertension and are not aware that they have it.
Diagnosed hypertension: Diagnosed hypertension is assessed by health care
physicians and can be promptly treated with pharmacotherapy or non-
pharmacotherapy.
Limitations:
This study will be limited to registered dental hygienists practicing in private
practice and public health settings in the state of Connecticut.
Delimitations:
This study excludes current dental hygiene students, dental hygienists that are
sales representatives, dental hygiene administrative positions, dental hygiene
educators, and dental hygiene advocates.

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Assumptions:
We assume that dental hygienists know the importance of blood pressure
screenings.
We assume that registered dental hygienists are educated on taking vitals and
determining normal versus abnormal readings.
Chapter
2
-­‐
Literature
Review
In light of the growing awareness of oral health and its connections to systemic
health, this study is designed to determine if registered dental hygienists are
taking vitals and blood pressure readings at dental hygiene appointments to
provide comprehensive patient care. By taking vitals at dental hygiene
appointments, the dental hygienist can assure the patient that sufficient care is
being taken by screening for hypertension, preventing medical emergencies, and
taking medical conditions into consideration that will interfere with treatment.
Many people are not aware that they have high blood pressure; this is why it is
known as the “silent killer.” A review of the existing literature suggests that 33%
of US adults over the age of 20 have hypertension (AHA, 2014). If dental
hygienists took regular vital signs and blood pressure readings at the patient’s
dental hygiene visits, they will have the ability to inform patients of their disease
status, prevent further advancement of the disease and prevent medical
emergencies. A potential problem that dental hygienists face in preventing them

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from completing these practices is not having enough time to take vitals and
blood pressure screenings (Greenberg, 2010).
The American Heart Association also states that 6% of Americans have
undiagnosed hypertension (2014). During a dental hygiene appointment, dental
hygienists have the option to provide patient comfort with the use of local
anesthetics. To a normal, healthy patient, this is ideal treatment; to a patient with
undiagnosed hypertension, this could raise a patient’s blood pressure even more
than it is already raised. According to a study on the influence of local
anesthetics on heart rate, local anesthetics that contain epinephrine could raise a
patient’s heart rate to a noticeable extent (Ketabi, 2012). Increased heart rate
can increase the chances of a medical emergency including myocardial
infarction, stroke, or angina (Thompson, 2007).
Dental Hygienists are taught the ADPIED method treatment of care. The first
letter “A” stands for the assessment stage. It is imperative that dental hygienists
take patients’ blood pressure at routine visits to assess health needs and provide
patients with the best treatment of care. If the patient is found with high blood
pressure during his or her dental visit, further investigation should be made to
address the need of the patient. It is important to know whether the patient’s
hypertension is controlled or uncontrolled. It has been proven that some
hypertension medications can cause xerostomia, lichenoid reactions, gingival
growth, severe bleeding, and delayed healing (Thompson, 2007). If the patient

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has uncontrolled hypertension, he or she is at a higher risk for angina,
myocardial infarction, or stroke. It is also known that most patients have dental
anxiety which could potentially increase the risk for medical emergencies
happening in a dental setting (Sproat, 2009).
Dental health care providers are responsible to identify high blood pressure and
provide immediate medical referral to the patient’s primary physician. According
to Sproat’s research study done in 2009, many practitioners do not feel that
dentists should perform blood pressure screenings at dental visits because it can
bring confusion to the patients about their overall health. In contrast, The British
Hypertension Society (BHS) indicates the need for an extended role for health
care providers such as nurse practitioners, pharmacists and other health care
professionals for hypertension detection purposes, early diagnosis, and early
treatment of the disease.
Chapter
3
-­‐
Methodology
This study will determine if registered dental hygienists are taking blood pressure
on patients at dental hygiene visits to provide comprehensive patient care.
Sample:
A survey composed of ten questions will be directed towards Registered
Dental Hygienists in the State of Connecticut. The survey will answer the
question of the number of dental hygienists who complete blood pressure
screenings on their patients during dental hygiene visits or what barriers they
might face in incorporating this preventive screening practice.

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Research
Design:
The research design will be mixed-methods; qualitative and
quantitative. Qualitative because the study will be completed utilizing a survey,
questioning dental hygienists under what circumstances they complete blood
pressure or what barriers they might face. Quantitative methods will be used to
summarize the results of the study.
Methods:
This study will be utilizing a survey with a combination of open-ended
and multiple-choice questions.
Data
Collection: Registered dental hygienists working in the State of Connecticut
will be able to complete the survey online. The survey link will be posted on the
Connecticut Dental Hygienists’ Association (CDHA) Facebook page and
potentially on their website.
Statistical
Analysis: For this research study, descriptive statistics will be utilized.
The research study will be conducted based on a ten question survey that will be
available to registered dental hygienists working in the state of Connecticut. The
data collected from the survey will be summarized using a Pie chart. In addition,
the survey will be using the measures of central tendency (mean, median, and
mode) in order to summarize the responses from the surveys.
Research
Question: Are registered dental hygienists taking proper blood
pressure screenings/precautions on each patient.
Hypothesis: Registered dental hygienists are taking proper screening
precautions on patients by taking blood pressure readings at each appointment.

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Equipment/Materials: For our research study we will be using both paper and
computer based software to analyze and summarize the data. No costs will be
involved.

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References
Bell, K. P., Phillips, C., Paquette, D. W., Offenbacher, S., & Wilder, R. S. (2011).
Incorporating Oral-Systemic Evidence into Patient Care: Practice
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Dental Hygiene, 85(2), 99-113.
Greenberg, B. L., Glick, M., Frantsve-Hawley, J., & Kantor, M. L. (2010).
Dentists’ attitudes toward chairside screening for medical conditions.
Journal of The American Dental Association (JADA), 141(1), 52-62.
Greenberg, B. L., Kantor, M. L., Jiang, S. S., & Glick, M. (2012). Patients'
attitudes toward screening for medical conditions in a dental setting.
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