This document discusses considerations for treating dental patients with diabetes. It notes that India has the highest rate of diabetes in the world, with over 72 million cases in 2019. The three most common oral signs of diabetes are gingivitis, periodontitis, and dental caries. It recommends checking a patient's blood sugar level prior to treatment, consulting their endocrinologist, scheduling morning appointments when cortisol levels are higher, and ensuring patients have eaten normally. Epinephrine and glucocorticoids can increase blood sugar and are relatively contraindicated. For patients allergic to standard anesthetics, alternative options would need to be considered.

1. Diabetes
And
Dental Treatment
Dr.Sunil Kumar
Instagram - doc_sunil_kumar

2. India is the Diabetic Capital of the world
72.9 Million people suffering from Diabetes
(2019 INDIAB Data)
8%

5. Diabetes
● What ,if patient lies?

6. Q1.
Polyurea,
Polydypsia,
Polyphagia

7. Q2. Wound healing?

8. Stiff Hand Syndrome- 50% old patient

9. Examine the oral cavity
3 most common features in
diabetes
● Gingivitis,periodontitis
● Dental caries
● Xerostomia
Ketonic smell from oral
cavity(Earliest sign of
diabetes)

10. If you still have doubt
● Go for RBS(Random blood sugar)Test

11. Considerations for Diabetic patient
● Sugar level should be taken prior to treatment
(Fasting sugar < 100-180) (HbA1C < 10%)

12. Considerations for Diabetic patient
● Consult their endocrinologist prior to treatment

13. Considerations for Diabetic patient
● Give Morning appointments
(Because endogenous cortisol levels are higher at
morning and cortisol increase blood sugar level so the
risk of hypoglycemia is less)

14. Considerations for Diabetic patient
● Pt. Should had eaten normally prior to appointment

15. Contraindication
● Epinephrine,Antagonise the
insulin and may result in
Hyperglycemia (1:100,000)
● Glucocorticoids increase the
blood glucose level

16. Question for you

17. If pt. Is allergic to both
anesthesia(amide and
ester)
What will you give as
anesthesia?

18. Thank you
Instagram-@doc_sunil_kumar