Dental Care in the Diabetic Patient
Oral health, proper care of teeth and gums are among the most important aspects that contribute to the control of diabetes and to an adequate nutrition.
There are several types of diabetes, the most common are:
- Type I Diabetes: There is a beta cell destruction that leads to a total deficit of insulin. The patient needs insulin as a treatment.
- Type II diabetes: There is an insulin resistance, this means that the body produces insulin but the organs don’t respond adequately to its stimulus. The patient will have to control his diet and sometimes take oral hypoglycemic agents.
- Gestational diabetes mellitus:It appears during pregnancy due to hormonal changes that are generated.
Periodontal disease is one of the factors that commonly contributes or precipitates the increase in glucose in diabetic patients that have poor glycemic control. This disease affects the gums and the tissue that surrounds the teeth and like diabetes it is a silent, progressive condition that is not recognized by the patient. It is often not identified by the doctor in early stages. This disease progresses from one stage of gingivitis, to periodontitis, where the infection affects the bone and as the condition progresses, it infects the tooth root and that promotes the loss of teeth. A comprehensive dental exam is part of a proper medical examination in the diabetic patient.
In recent years it has been recognized and scientifically validated that strict control of diabetes prevents or slows the presence of chronic complications of the disease. It is emphasized to make an effort to reach values of glucose similar to those of non diabetic individuals. Dentists who often receive in their offices people with severe periodontal disease might not know that they have diabetes. Many diabetic patients do not visit the dentist because they understand that if they don’t have their glucose under control, the dentist will not perform the necessary dental procedures and they continue perpetuating this chronic disease of their gums and eventually they lose their teeth. Tooth loss leads to nutritional problems and even self-esteem problems that cause anxiety, depression and they contribute to the bad control of diabetes.
The dental treatment of each patient is very special and individualized even for those patients with good control of their diabetes, because of the multiple factors that can alter the control of their diabetes. Among the factors, which may alter glycemic control, we have infection, the alteration in the timing of meals and stress by the procedure. The most common dental procedures in diabetic patients are:
Dental extractions
Periodontal surgery
Transapical Endodontics
Treatment of infection
Prosthesis
Restorative Dentistry
Endodontics
Orthodontics
Fluoride Treatments
For these procedures it is recommended to control diabetes with oral medications and / or insulin, management of stress before the procedure, pain management, antibiotic use and organize the diet and snacks as as to prevent hypoglycemia.
Appointments for dental treatments should be preferably scheduled in the morning and you should maintain regular assessments with your dentist to prevent complications. There are several conditions that put your teeth in danger and
one of these is diabetes, in addition to smoking, having a family history of periodontal disease, pregnancy and the use of certain drugs like steroids, contraceptives, antihypertensive drugs and chemotherapy.
A proper preventive dental care contributes to oral health and this in turn provides a balanced nutrition, that promotes better diabetes control and the prevention of acute and chronic complications of this condition. Visit your dentist regularly; oral health is very important for all and particularly for the diabetic patient.
A healthy dentition contributes to a better nutrition, to improve glycemic control and it also fosters a positive image and a responsible attitude to all areas of their health.
