Published on Dec 27, 2018 and last reviewed on Feb 28, 2023 - 3 min read
This article emphasizes the impact of diabetes mellitus on oral health problems and its management.
Diabetes mellitus is a metabolic disorder which affects the uptake and use of glucose by the human body. As a result, the glucose level in the blood rises beyond normal which has an overall impact on the general health and oral cavity.
Types Of Diabetes
There are several oral manifestations of diabetes mellitus. These are:
Complications During Dental Surgery and Tooth Extraction
Management of Diabetic Patient with Oral Problems
When Should One Do Extraction
First, ask the patient for fresh tests like fasting blood glucose level and postprandial level.
Ask the patient for CBC (complete blood count) and CTBT (clotting time and bleeding time) to avoid complications from bleeding.
Before a major surgery, ask the patient to take the consent of an endocrinologist as well.
If these tests are normal, then go for extraction and if these are not normal, send the patient to the endocrinologist for management till investigations return to normal.
Ideally, the dentist should ask the patient to bring fasting blood glucose report and monitor postprandial level before extraction. After extraction, the postprandial test should be repeated after two hours. It is always better to keep the patient on monitoring for two hours after surgery or extraction.
Ideally, it is better and safer to do an extraction after the patient has taken food because one can compromise with hyperglycemia but not with hypoglycemia.
Between fasting glucose level of 110 to 125 mg/dl, one can do the extraction and less than 140 mg/dl after measuring postprandial levels.
If the patient has well-controlled diabetes, oral hypoglycemic drugs can be stopped for 24 hours prior to extraction or minor surgery. But glucose levels need to be monitored pre and postoperatively for two hours until the patient eats again and medication is to be started again.
However, if the disease is poorly controlled, the patient may require insulin before surgery. For such cases, the consent of an endocrinologist must be taken.
As a final note, if you find any diabetic patient, always explain to him/her the preventive measures to maintain good oral health. If you have sufficient technical and manpower support, then go for extraction. But, if you have problems of poor infrastructure, it is always wise to send the patient to an established government or private hospital. If the patient has poor diabetic control, never hesitate in referring the patient to an endocrinologist.
Every other individual is affected by diabetes. Diabetes causes increased sugar levels which cause poor wound healing. In addition, it increases the risk of tooth decay and tooth mobility. Hence diabetic patients need to visit their dentist once in six months to undergo scaling and identify dental problems at an earlier stage.
Diabetes increases the level of sugar in saliva. This helps the oral bacteria to multiply and cause tooth decay rapidly. In addition, it increases the risk of tooth loss and helps to adhere food particles to the tooth surface due to the sticky saliva.
Periodontitis is the sixth major symptom in patients with diabetes. Periodontitis refers to the inflammation and infection of the tissues supporting the tooth and covering the bone. Severe periodontitis results in tooth mobility, eventually resulting in tooth loss.
Diabetes increases the risk of tooth loss in patients with poor oral hygiene. Hence diabetic patients have to pay extra attention to their teeth and visit dentists regularly for a thorough cleaning and dental check-up. In addition, using dental floss and mouthwash can prevent the risk of caries susceptibility.
Dryness of mouth, also called xerostomia, is associated with diabetic patients. Individuals with high glucose levels are more prone to mouth dryness. Artificial saliva and consumption of citrus fruits are advised in patients with dry mouths to induce salivary secretion.
The following are the risk factors of diabetes:
- Family history of diabetes.
- Lack of physical activity.
- Gestational diabetes.
Diabetes causes mouth dryness which results in ulcer formation. It also increases the risk of mouth soreness and causes fungal infections like candidiasis. Mouth ulcers can be painful and cause difficulty in chewing food.
Diabetes is prone to cause gum-related infections like periodontitis. It weakens the peripheral support of the tooth resulting in tooth mobility. Gum infections are a common indicator of diabetic patients.
The white tongue in diabetes is caused by a fungal infection called candidiasis. This infection usually occurs in the tongue and hard palate. It is non-scrapable and can be treated with antifungal drugs.
Diabetic patients have dry and cracked lips, which may bleed in severely damaged cases. Applying lip balms and petroleum jelly can help to keep the lips moist and prevent dryness. Also, drinking adequate water helps to hydrate the body.
Medicated mouthwashes must be used as the dentist recommends for a stipulated period. Prolonged use of mouthwash can stain the teeth. However, mouthwash is not a potent cause of diabetes. It is an additional oral hygiene measure to protect teeth and gums from microorganisms.
The tongue comprises multiple tiny taste buds that help to recognize different tastes as food is swallowed. In diabetic patients, these taste buds are damaged due to excess sugar consumption. It results in oral candidiasis, a fungal infection that can be effectively treated with medications.
Last reviewed at:
28 Feb 2023 - 3 min read
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