Personally, I MUST measure the BP before any surgical procedure, or a very long procedure.
I dont treat any pt's with BP above 160/110 period. Although they get upset but I tell them that it is their best interest to have their bp adjusted, instead of leaving my office in the ambulance, and they appreciate it. Alot of times pts would tell me "hey I never had my BP measured before in a dental office, you guys must know what you're doing"
What I was taught duing my residency like everyone here, is that the amount of endorphins released from pain and fear is far more than the 1:100,000 epinephrine in your lidocaine. A good profound local anesthesia would not increase the bp significantly. Before I start an extraction, with an explorer I make sure that everything around the tooth Im dealing with is numb.
But my guess at dental school, professors want to teach their students the ideal way of treating pt's and to have the habit of referring to physician if needed.
I had a pt faint in my chair and her bp was 117/76 with no health conditions, she fainted because she didnt eat for almost a day because of the pain she had. BP isnt the only thing you should look at before starting the procedure.
Make sure your pt isnt exhausted and ate and most importantly has taken his meds. If diabetic pt ask whats the last blood sugar level was, if significantly high also refer. Diabetic pt's tend to not to eat nor take their meds before going to a dentist for some reason.
I hope this helps good luck 👍
