Diabetes mellitus management and consideration in dental office
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This document discusses oral manifestations and complications of diabetes mellitus. It notes that periodontal disease is more common in diabetics due to factors like hyperglycemia, microangiopathy, and altered immune response. Other oral issues include xerostomia, dental caries, infection risk, delayed wound healing, and drug side effects. Dental management of diabetics requires consideration of their medical history, glucose levels, medications and scheduling appointments when blood sugar is most stable. Hypoglycemia during treatment requires oral carbohydrates, while hyperglycemia may need medical intervention and insulin.
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This document discusses oral manifestations and complications of diabetes mellitus. It notes that periodontal disease is more common in diabetics due to factors like hyperglycemia, microangiopathy, and altered immune response. Other oral issues include xerostomia, dental caries, infection risk, delayed wound healing, and drug side effects. Dental management of diabetics requires consideration of their medical history, glucose levels, medications and scheduling appointments when blood sugar is most stable. Hypoglycemia during treatment requires oral carbohydrates, while hyperglycemia may need medical intervention and insulin.
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The document discusses dental management considerations for patients with diabetes. It notes that periodontal disease is more common in patients with poorly controlled diabetes. Other oral complications that may be associated with diabetes include xerostomia (dry mouth), fungal infections, oral burning sensations, and delayed wound healing. The dental provider should assess the severity and control of the patient's diabetes and educate them on oral health risks from their condition.
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Amelogenesis imperfecta is a hereditary condition that affects the development of dental enamel. There are three main types - hypoplastic, hypocalcified, and hypomaturation. The enamel is either not fully formed, not properly mineralized, or does not mature correctly. Treatment depends on the specific type but can include preventative care with sealants, bonding, crowns, veneers, and in severe cases, full coverage restorations. Managing the condition over many years using various techniques can lead to excellent functional and aesthetic outcomes.
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In these powerpoints I describe how to control glycemia in the perioperative period in patient with diabetes not taking insulin. Please download these slides and view them in PowerPoint so you can view the annotations describing each slide.
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Diabetes mellitus management and consideration in dental office
- 1. DIABETES MELLITUS CONSIDERATIONS IN DENTAL OFFICE Presentedby:M.R.Vatankhah
- 2. Intro.
- 3. Imp. Medical features ■ Diagnostic criteria for diabetes mellitus: – FPG 8hrs. > 126 mg/dL – S&S + random blood glucose ≥ 200 mg/dL – 2hrs. Post-load blood glucose ≥ 200 mg/dL – A1C assay ≥ 6.5 %
- 4. Imp. Medical features A1CPostprandial P GPremeal P G* 4-6%<140<100 (mean = 90)Normal <7%<18090 – 130ADA targets
- 10. History
- 11. Aims ■ Final aim: correcting both oral infection & plasma glucose level. ■ Major goal: not occurring insulin shock
- 12. Analgesics ■ Avoid use of aspirin and other NSAIDs in patients taking sulfonylureas because they can worsen hypoglycemia.
- 13. Antibiotics ■ Prophylactic antibiotics generally are not required. ■ Brittle diabetes for whom an invasive procedure is required ■ Oral health is poor + FPS > 200 = I&D , Ext. , pulpotomy, ABTherapy
- 14. Anesthesia ■ No issues if diabetes is well controlled. ■ MI, cardiac arrhythmia : <2 cartridges containing 1:100.000 epi. (MET<4) ■ No need for extra anxiety and allergy control.
- 15. BP & bleeding & CVD ■ Diabetes is associated with hypertension. ■ Thrombocytopenia is a rare adverse effect associated with sulfonylureas. (bleeding control) ■ Beta-blocker drugs can exacerbate hypoglycemia in patients taking sulfonylureas.
- 16. Diabetes and Acute Oral Infections
- 17. Oral Manifestations. Diabetesoral manifestations Xerostemia Poor healing PA abscesses Increase in caries incidence Bacterial & Gingivitis & periodontitis
Editor's Notes
- Pallor: کم رنگی Incoherence: لکنت Belligerence; کج خلقی