Diabetes affects abnormalities in the blood vessel walls, peripheral nerves, kidneys, and retina in the oral cavity. When the mouth of a diabetic patient becomes infected, there is pain due to poor oral health, increased resistance to insulin, and loss of blood sugar control. If diabetes is poorly controlled, complications from diabetes may increase.
Dental Management Guidelines for Diabetic Patients
Diabetic patients with prolonged elevated blood sugar levels experience pathological imbalances in the capillaries of the gums and peripheral nerves. They may have dry mouth, pain, burning sensation in the oral cavity, swollen salivary glands, loss of taste, and a high risk of periodontitis. They are more sensitive to bacterial or fungal infections in the mouth. Therefore, it is essential for diabetic patients to receive dental check-ups and treatment at least twice a year to maintain oral health and help reduce complications from diabetes.
- Schedule treatment appointments in the morning so that patients can eat and take medication, helping to minimize stress from treatment and prevent hypoglycemia, which can be life-threatening.
- Provide dental treatment as usual if blood sugar is well controlled (<126 mg/dL) or not higher than 200 mg/dL. In cases of tooth extraction or minor surgery, the dentist will carefully trim the teeth to reduce the risk of infection or osteonecrosis, which may occur more easily than in normal patients.
- Postpone treatment or treat only emergency symptoms with consideration of using antibiotics to prevent infection and immediately refer to a physician if blood sugar is higher than 200 mg/dL.
- Treat only emergency symptoms and immediately refer to a physician if the patient is undergoing insulin treatment and experiences hypoglycemia (<70 mg/dL). They should drink sugary water or suck on candy immediately to raise blood sugar levels.
