DENTAL CARE FOR DIABETICS
Written by: Dr Tin Maung Maung - WF Knobel Hospital, Lonsdale
Placed with Dr Maung Maung's
Oral hygiene care for the diabetic patient is of paramount importance. The oral health team has the sole responsibility of providing the diabetic patient with oral health care and instruction for self care with the aim of promoting monitoring and preventing gingival and periodontal diseases which are the potential source of infection in the oral cavity.
There is no specific oral changes in diabetic patient although manifestations of lowered resistance to infection can be seen in poorly controlled cases in the form of periodontal abscess and severe periodontal disease.
The oral mucusa, tongue gingiva and periodental tissues of a diabetic patient may show unusual susceptibility and have a tendency towards more marked reactions to trauma, infections and local irritants like calculus and plaque than do tissues of non diabetics.
ORAL CAVITY (COMPLICATIONS)
Dry mouthy and thirst predisposes oral cavity, pharynx and salivary gland to infection and dental decay.
Burning sensation of the mouth may be a presenting feature of diabetics and oral or facial dysaesthesia may reflect the peripheral neuropathies seen in diabetics.
To date there is no known care for diabetics. The sucess of patient treatment depends upon the knowledge, understanding and attitude of the patient.
It also depends on how well the condition is managed in a day to day basis.
Self care measures for plaque control are selected on the basis of individual needs.
Continuing supervision , monitoring and review of recommended procedures is critical to the diabetic patient because of increased susceptibility to periodontal tissue involvement.
The diabetic patient should inform the dentist about the clinical condition whether they are taking the medication regularly or not and whether they are on diet alone or diet and drugs or on an Insulin regime.
The best time to make an appointment with the dentist is early in the morning, preferably after having a good breakfast and after taking the usual dose of Insulin / Oral Hypoglycaemic drugs. They should visit their dentist once every 4 to 6 months without fail.
ORAL HEALTH TEAM
The oral health care providers should determine the patients' interest, wishes, beliefs and values regarding oral health.
They must supervise and monitor the patients current oral self care practices.
All minor oral surgical procedures should be performed under Antibiotic cover as prophylaxis against wound infection.
It is advisable to do a blood glucose test in poorly controlled diabetics and those who need to be treated under General Anaesthesia for surgical procedures is best referred to a Medical doctor or the Anaesthesist.
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TomTom Interactive Communiations: 31 January 2000
SADA Pretoria: 24 March 2001