Around family and friends, people tend to be comfortable and relaxed. However, around doctors or anyone wearing a white coat, some patients experience a slight spike in their blood pressure, displaying the phenomenon known as white coat syndrome.

Whether it’s a patient’s first time with a medical professional or an unpleasant memory of a previous visit, there is a vast range of causes for and risks to white coat syndrome. Affecting more than 35% of the global population, dental fear is prevalent. It’s critical that dental students prepare to counter the many implications of white coat syndrome.

First, what is white coat hypertension or white coat syndrome? It is when a patient experiences a small or temporary increase in his or her blood pressure only in a medical setting. Patients who suffer from white coat syndrome are reported to be mostly older, non-smoking women and people recently diagnosed with mild hypertension.

While white coat syndrome may seem harmless, some researchers believe the mild hypertension it causes can lead to severe effects including kidney damage, aorta stiffness and other cardiovascular implications. They believe white coat syndrome could lead to sustained hypertension. A study that measured the long-term risks of people with and without white-coat hypertension also reported that untreated patients with white coat syndrome had increased risks of new-onset diabetes mellitus among others within a 10-year follow-up period.

To overcome blood pressure spikes, possible oral emergencies and other white coat syndrome-related effects, some dental clinics offer patients sedation options including nitrous oxide, IV sedation and oral sedation. The purpose of sedation is to make patients’ dental visits more comfortable through minimizing anxiety, controlling pain levels and, in some cases, helping the patient forget the office visit entirely. These options are less invasive and expensive than general anesthesia, benefitting the dentist and the patient.

Besides sedation options, some dentists are trying other ways to lower patients’ risks of white coat syndrome. There are dentists who don’t wear their white coats anymore to create a more friend-like interaction and more productive communication with patients. Further, some doctors of pediatric patients who commonly display the effects of white coat syndrome are exchanging their formal white coats for colorful scrubs and personal protective equipment to create a more relaxed clinical environment. These changes are meant to reduce adult and pediatric patients’ fear of the dental clinic.

The white coat is often seen as a symbol of achievement and respect for medical professionals. However, some dentists are willing to shed this badge, or in this case, coat of honor to place the patient first and wipe out white coat syndrome and its undesirable effects.

~ Jihoon Jun, Northeastern University ‘23