Hypertension is one of the most common comorbidities in Malaysia mandating the need for screening prior to dental treatment to identify undiagnosed cases and ensure safe delivery of care. A standard protocol is imperative to guide dental practitioners to manage their patients based on the blood pressure readings. This study identifies the prevalence of known and unknown cases of hypertension in patients attending Universiti Sains Islam Malaysia (USIM) Dental Clinic and proposed a working clinical algorithm to be used for dental patients with abnormal blood pressure. It involves a retrospective study of 386 patients from the year 2017 until 2021. All data were analysed using Statistical Program for Social Science (SPSS) version 28.0. A literature review was also done to construct a clinical algorithm. The prevalence of patients with known hypertension in our study is 33.2% and 29.8% of them presented with unknown elevated blood pressure reading. Only 9.3% of uncontrolled and unknown cases were actually given referral for medical assessment. The presence of patients unaware of their possible hypertensive condition warrants the need for screening prior to dental treatment, hence the need for a standard protocol for all dental practitioners.