Diabetes Awareness Month: Managing a Patient with Diabetes in the Dental Office
According to recent figures from Diabetes Canada, almost 10% of the Canadian population has been diagnosed with either Type 1 or Type 2 diabetes. But what is of greater concern is the prevalence of undiagnosed and pre-diabetes which stands at almost 30% of the population.
In this short discussion, Dr. Bruce Yaholnitsky, periodontist from Calgary, AB, shares some key strategies in managing an individual with diabetes in the dental office and highlights the important role dentists play in the diagnosis of this condition and in the general health of their patients.
“Diabetes is a growing problem and dentists need to be aware of what they are dealing with. It is important for them to realize that they are part of the general health of that patient.”
Dr. Bruce Yaholnitsky
CONTROLLED VS. UNCONTROLLED DIABETES
One key factor in the management of a patient with diabetes is whether their disease is controlled or uncontrolled. A well-controlled diabetic patient can be treated quite routinely in the dental office where we are likely to see normal oral health and normal levels of disease.
However, when the diabetes is uncontrolled, it is of much greater concern and tends to lead to more oral and general health issues.
SIGNS AND SYMPTOMS OF DIABETES IN THE DENTAL OFFICE
The following oral health symptoms are common in patients with uncontrolled diabetes:
- Dry mouth (xerostomia)
- Candida or yeast infections on the mouth for unknown reasons
- Unexplained abscesses and acute infections in the mouth
- Active periodontal disease with suppuration
If the patient has not been diagnosed with diabetes and is also experiencing frequent thirst, general malaise, and frequent urination, it may be necessary to refer that patient to a physician for an assessment of blood sugars.
DENTAL MANAGEMENT OF INDIVIDUALS WITH DIABETES
- Individuals with controlled diabetes can be treated mostly as non-diabetic patients. When a patient’s diabetes is uncontrolled, we are likely dealing with more emergency and acute situations and there is some benefit to seeing these patients more frequently.
- Poor healing and a higher risk of developing an infection mean that diabetic patients are frequently prescribed antibiotics for surgical procedures.
- Patients with diabetes are more prone to periodontal infection. If these infections are uncontrolled, it may be time to refer the patient to a periodontist, or in some cases, a maxillofacial surgeon.
- When booking appointments, consider asking the patient what time of day is best for them in terms of glycemic control. Consider keeping a bottle of fruit juice in the operatory in case of a hypoglycemic event.
BIDIRECTIONAL CORRELATION BETWEEN PERIODONTAL DISEASE AND DIABETES
The bidirectional correlation between periodontal disease and diabetes is well documented. It is very important for diabetic patients to have good home care, good debridement of root surfaces and a clean mouth. This will help them to control their diabetes. Controlled diabetes will in turn help control periodontal disease.
We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.
Until next time!
CDA Oasis Team