Cardiovascular medications

Dental Considerations for Patients Taking Beta-blocker — non-selective (propranolol)

Limit adrenaline (non-selective beta-blocker)

Record of propranolol (non-selective beta-blocker). The points below cover relevant oral side-effects and drug interactions so prescribing and treatment remain safe and non-conflicting.

Emergency vs routine management

If EMERGENCY — what to do

• Limit adrenaline to 0.04 mg (≈ 2 cartridges of 1:80,000–1:100,000), aspirate and inject slowly.Ref: Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023
• Monitor BP — risk of hypertensive response with reflex bradycardia.Ref: Stockley's Drug Interactions (current edition)

If ROUTINE — what to do

• Routine care with limited adrenaline; avoid adrenaline-impregnated retraction cord.Ref: Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023

Clinical precautions

• Non-selective beta-blocker: limit adrenaline (risk of hypertensive response); use the minimum effective dose and aspirate.
• Avoid adrenaline-containing retraction cord.
• Avoid prescribing drugs that interact; verify any new prescription against the patient's full medication list.

At a glance by procedure

Initial assessment before lab results or timing details are entered.

Procedure	Initial assessment
Examination / radiographs	MODIFY / CAUTION Limit adrenaline (non-selective beta-blocker)
Supragingival scaling / polish	MODIFY / CAUTION Limit adrenaline (non-selective beta-blocker)
Deep scaling / subgingival RSD (subgingival calculus)	MODIFY / CAUTION Limit adrenaline (non-selective beta-blocker)
Root canal treatment	MODIFY / CAUTION Limit adrenaline (non-selective beta-blocker)
Simple extraction (1–3 teeth)	MODIFY / CAUTION Limit adrenaline (non-selective beta-blocker)
Surgical / bony extraction	MODIFY / CAUTION Limit adrenaline (non-selective beta-blocker)
Implant placement	MODIFY / CAUTION Limit adrenaline (non-selective beta-blocker)

Get a patient-specific decision in seconds

Combine all conditions, medications, lab results and the planned procedure — with anaesthetic dose calculation, lab requests and a referral letter PDF.

References

Drug considerations in dentistry (oral side-effects & interactions)
Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023
Stockley's Drug Interactions (current edition)

This guide supports — and does not replace — professional clinical judgment. Always consider the individual patient and consult the treating physician when indicated.