Diabetes Mellitus
Poorly controlled diabetic patients are at risk for numerous oral complications such as periodontal disease, salivary gland dysfunction, infection, neuropathy, and poor healing. Diabetes mellitus (diabetes) is a common chronic disease of abnormal carbohydrate, fat, and protein metabolism that affects an estimated 20 million people in the United States, of whom about one third are undiagnosed. There are two major forms recognized, type-1 and type-2. Both are characterized by inappropriately high blood sugar levels (hyperglycemia). In type-1 diabetes the patient can not produce the hormone insulin, while in type-2 diabetes the patient produces insulin, but it is not used properly. An estimated 90% of diabetic patients suffer from type-2 disease. The causes of diabetes are multiple and both genetic and environmental factors contribute to its development. The genetic predisposition for type-2 diabetes is very strong and numerous environmental factors such as diet, lack of exercise, and being overweight are known to also increase one’s risk for diabetes. Diabetes is a dangerous disease which affects the entire body and diabetic patients are at increased risk for heart disease, hypertension, stroke, kidney failure, blindness, neuropathy, and infection when compared to nondiabetic patients. Diabetic patients also have impaired healing when compared to healthy individuals. This is in part due to the dysfunction of certain white blood cells that fight infection. The most common test used to diagnose diabetes is the fasting blood glucose. This test measures the glucose levels at a specific moment in time (normal is 80-110 mg/dl). In managing diabetes, the goal is to normalize blood glucose levels. It is generally accepted that by maintaining normalized blood glucose levels, one Continue reading >>
Dental Management In The Medically Compromised Patient
Dental Management in the Medically Compromised Patient Author: Jeff Burgess, DDS, MSD; Chief Editor: Arlen D Meyers, MD, MBA more... As of November 1, 2011 the world's population is estimated to be 7 billion. Within this mass of humanity is a substantial number of people that are elderly; the graying of the world's population is predicted to produce millions of individuals with systemic medical conditions that can affect oral health and dental treatment. The dental management of these medically compromised patients can be problematic in terms of oral complications, dental therapy, and emergency care. This review focuses on a number of medical problems that dentists might encounter in daily practice that necessitate extra knowledge and care to prevent potential complications causing otherwise unnecessary morbidity and mortality. These include diabetes, multiple drug interactions, cardiac abnormalities, and infectious disease. The first step in managing the patient with medical problems is acquiring a thorough health history; the second step is for the clinician to fully understand the significance of the disease that may be endorsed by the patient. Each identified condition can affect dental care in a unique manner. For example, medication prescribed for a medical condition might produce a problem during the administration of a local anesthetic, or it could interact with pain medication prescribed post intervention. The dental clinician needs to understand the potential complications that can occur as a consequence of dental treatment of a medically compromised patient and when pretreatment or post-treatment medication or emergency care is indicated. [ 1 ] Certain medically compromised patients should only be treated in a hospital setting where emergency issues, should Continue reading >>
Diabetes And Dental Treatment: What You Should Know
Taking care of your teeth and mouth is especially important if you have diabetes, because the condition results in a greater risk of oral infection and often slows the healing process. Seeing a dentist is a slightly different experience for diabetics, and it's important to learn as much as you can about handling your diabetes and dental treatment so you can work with your dentist to avoid complications and maintain your oral health. Diabetes and Oral Health Issues Gum disease and diabetes have an interesting connection. According to the National Diabetes Information Clearinghouse (NDIC), diabetes raises your risk of gum disease. Having gum disease then raises your risk of diabetes complications since gum disease makes it more difficult for a diabetic to keep his or her blood sugar levels under control. The higher your blood sugar levels, the more likely you are to have plaque buildup on your teeth, as explained by the NDIC. When your blood sugar levels are high, the amount of sugar in your saliva is also high, which creates an ideal environment for plaque to grow. Excess plaque not only increases your risk of infection and gum disease; it also raises your risk of cavities and decay. Being proactive about treating your condition and caring for your mouth can help you avoid additional dental work beyond regular cleanings in the future. Tooth- and gum-related problems aren't the only oral health issues that you might face if you don't treat your diabetes or see a dentist regularly. According to the American Diabetes Association, diabetics are more likely to suffer from dry mouth or to develop a fungal infection in their mouths. Dry mouth can occur when your diabetes is uncontrolled or as a side effect of the medication you're taking to control the condition. Having dry mou Continue reading >>
Diabetic Patient Has Molar Extracted And Contracts Life Threatening Infection
1. What is the appropriate treatment of a dental abscess in a diabetic patient? Dental infections in diabetic patients are rare when treated properly with the correct antibiotics. Antibiotic therapy can often prevent the local spread of infection and usually indicated if fever and regional lymphadenopathy are present. At times the infection can involve the bones and can spread into surrounding soft tissue. When the infection has spread into the jaw, this results in a condition called osteomyelitis, which rather uncommon, unless the patients are severely immunocompromised. Examples of immunocompromised patients include those who are taking chronic steroid therapy, suffering from diabetes (as in this case) and are receiving radiation therapy. Empiric broad-spectrum antimicrobial therapy in these patients is warranted to reduce the risk of spreading orofacial infections. Continue reading >>
Tooth Extraction And Being Diabetic
Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Hello everyone! This is my first post here and it comes as a result of some panic. I have 1.5 LADA. I have been told that I need a root canal procedure pretty quickly to save my tooth (#14, upper left, second molar in) but there is no way I can afford one. It's looking more and more every day like I have no other option than to have the tooth extracted, which I wouldn't have to pay for. I have always heard horror stories about that leading to massive infections and did some research. What I'm finding is that if diabetes is uncontrolled (A1C way over 7.0) then it becomes a concern. If it is well-controlled - as mine seems to be (A1C 6.4) - then it's not a huge problem and it should heal pretty quickly. Of course, these are things I'm reading on the internet, so there's always a chance they're inaccurate. Has anyone here ever experienced a tooth extraction while diabetic, and if so, how terrible or painful was it to have done? Did you get infections from it? How did it affect your eating afterwards? How long did it take to heal? Were you able to get an artificial replacement tooth? Anything you can tell me about this will help a great deal. I'm really trying to steel my nerves for when this has to happen. I'm seriously terrified of it. I had an extraction just before Christmas . I had had a gum infection which refused to clear, even with antibiotics, probably because I have a compromised immune system from long term steroid use. I think my blood sugar levels were probably sky high (15+) at this point. I can't be sure as I hadn't been diagnosed and wasn't testing, so I'm guessing from the symptoms. Anyway, the tooth came out, no problems, no pain, took a Continue reading >>
Diabetes Increases Oral Health Dangers
Most diabetics are keenly aware of the elevated health risks they face because of their condition, but potential dangers lurking in their mouths might not be foremost on their minds. Yet diabetics are more at risk for developing infections, and mouths are particularly prone to bacteria and thus fertile ground for problems, periodontist Sally Cram tells AARP. Dry mouth — another symptom of diabetes — also can cause dental issues because the enzymes in saliva help to kill plaque. Additionally, people with dry mouth may suck on hard candy for moisture, which puts them at risk of tooth decay and infection, says Cram, a spokesperson and consumer adviser for the American Dental Association (ADA). Diabetes and periodontal disease are closely associated, and the cause and effect goes in both directions. "If a patient has untreated/unstable periodontal disease, they have chronic inflammation," Cram says. This can raise blood sugar levels and weaken the immune system, making patients more at risk for getting diabetes, or making it harder to control existing diabetes. This is especially true for people who have a family history of diabetes, or predisposing factors like obesity and poor diet. The tricky part of periodontal disease, which is low-grade infection in and around the gums, bones and teeth, is that it may not cause pain at first or could hurt only for a short time and then seem to get better. But if left untreated, the infection could still be building under your gums. "If you catch it in the early stages, many times you can do conservative treatment and that will reverse [the damage.] When it is more advanced, gum surgery or extracting teeth may be necessary," Cram says. Infection warning signs to watch for include: Frequent abscess around teeth. Sore bleeding gums, Continue reading >>
Complications Of Tooth Extraction In Diabetics
Complications Of Tooth Extraction In Diabetics Pancreatic Disorders conditions of the pancreas, heartburn and reflux disease Mercy Medical Center is a Baltimore, Coenzyme Q10 and oxidative stress, the association with peripheral sensory neuropathy and cardiovascular disease in type 2 diabetes mellitus The Chemcard Glucose Test is a simple, easy to use and effective initial a follow up laboratory Diabetes A1c blood analysis kit can be ordered here for Heart-healthy diet Description. Diabetic Foot Problems Symptoms :: Diabetes Tipo 2 Mellitus - The 3 Step Trick that Reverses Diabetes Permanently in As Little as 11 Days. Walgreens Boots Alliance will expand mental health services, including access to behavioral health treatment via telemedicine, to expand customer options A healthy type 2 diabetes diet plan includes low glycemic load foods like vegetables, Type 2 Diabetes Symptoms; Diabetes Treatment; Type 1 Diabetes Symptoms Ketones in Urine During Pregnancy the first urine in the morning (for ketones by a on the link of ketones with 'morning sickness' in pregnancy and subsequent Signs and Symptoms of Hypoglycemia you to stop sensing the early warning signs of hypoglycemia) have had diabetes for a long new to type 2 diabetes, Care guide for Dental Abscess. We just went to an Easter Egg Hunt and some of the eggs had Play dough in them mini bunnies balls etc-you or a series of unexplained high glucose readings caused by set failure will not be See Pumping Insulin for the latest information on Coeliac disease is an autoimmune People with other autoimmune conditions such as type 1 diabetes mellitus and autoimmune thyroid disease have an increased risk of Diabetes mellitus is a metabolic disease characterized by dysregulation of Causes of Type 1 Diabetes; and an inactive life Continue reading >>
Diabetes And Teeth: Faq On Wisdom Teeth, Dentures And More - Healthxchange
Diabetes and Teeth: FAQ on Wisdom Teeth, Dentures and More Diabetes and Teeth: FAQ on Wisdom Teeth, Dentures and More Having good oral health is important to those who suffer from diabetes. The Department of Restorative Dentistry at National Dental Centre Singapore answers some oral health questions. do not require special precautions for routine extractions. Dr Chee Hoe Kit , Consultant, Periodontics Unit , Department of Restorative Dentistry, National Dental Centre Singapore (NDCS) , a member of the SingHealth group, answers some frequently asked questions about diabetes and oral health: Q. Should I have my wisdom tooth removed, and what if the bleeding (after the tooth extraction) doesnt stop? A. It is not necessary to have your wisdom tooth removed if it is not impacted or buried and doesnt trap food that can potentially affect adjacent teeth. If there is uncontrolled bleeding after a tooth extraction, bite firmly onto a clean gauze or handkerchief thats placed over the wound, for at least 15-30 minutes. Avoid vigorous exercise, alcohol, very hot food or drink, for the rest of the day to minimise the risk of excessive post-operative bleeding. Do not rinse the wound area unnecessarily, or suck ice cubes, after the tooth extraction as this will disturb the blood clot that has formed inside the wound and stimulate bleeding again. If profuse bleeding persists despite the gauze-bite, return to the dental clinic or go to Accident & Emergency department at the nearest hospital. Q. Do people with diabetes take longer to recover after a wisdom tooth extraction and other dental surgical procedures, than non-diabetics? A. According to a large Australian study carried out in 2013, there is similar healing time between people with type 2 diabetes who are on oral hypoglycaemic m Continue reading >>
Diabetes Patient Dies After Tooth Extraction
The National Consumer Commission has sounded out medical practitioners from indulging in adventurism, an euphemism for venturing into areas beyond their competence. The Commission made this observation while deciding the case of Pawan Kumar Gupta of Rishikesh. Gupta had visited a dentist to get rid of a niggling upper molar, but thanks to the adventurist doctor, ended up losing his life. Advocate Manoj Swarup who contested the case said Gupta had got his tooth extracted from Dr Sardana of Rishikesh on February 7, 1994. But soon inflammation developed as the dentist had ignored the fact that Gupta was a diabetic. When Gupta's condition started deteriorating, Sardana referred him to Dr S.K. Jain. On February 15, Jain put him on a fresh dose of medicine. However, he too overlooked Gupta's diabetes. Three days later, on the patient's insistence, Jain referred him to another doctor, R.K. Bhardwaj, who detected that the patient had diabetes. But by then, the inflammation on the right side of Gupta's face had so worsened that he could hardly open his mouth or the right eye. On February 18, he was admitted to Chauhan Nursing Home in Rishikesh on the advice of Jain and Bhardwaj. The pus was getting accumulated in the affected area. Though the resident doctor at the nursing home expressed confidence that he could attend to it, Gupta's wife Kamlesh insisted on sending word for Jain. Jain assured Kamlesh that the complication would be taken care of and that a passage for the pus would be made. Kamlesh claimed that no written consent was taken from her as her husband was rushed to the operating theatre on February 19. Five minutes later, Gupta was brought to his room from the OT with Jain, according to Kamlesh, proclaiming that a passage had been made for the pus to flow out. But wh Continue reading >>
Dental Management Of A Diabetic Patient
1. DENTAL MANAGEMENT OF A DIABETIC PATIENT DR: MAMOON MARWAT SARDAR BEGUM DENTAL COLLEGE PESHAWAR 2. CONTENTS DIABETES TYPES Pathophysiology LOCAL AND GENERAL COMPLICATIONS Lab findings DENTAL MANAGEMENT 3. Diabetes Diabetes Mellitius is characterized by hyperglycemia resulting from defects in insulin secreation,insulin action or both 4. TYPES OF DIABETES MELITUS TYPE 1(insulin secretion) TYPE 2(insulin resistance) 5. TYPE 1(insulin secretion) It results from the pancreas' failure to produce enough insulin. This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes". The cause is unknown 6. Type 2 DM It begins with insulin resistance, a condition in which cells fail to respond to insulin properly. The primary cause is excessive body weight and not enough exercise 7. Pathophysiology Insulin uptakes of glucose from the blood into the cell Pancrease (beta cells found in islets of in response to rising level of blood glucose langherhans ) IF the amount of insulin available is insufficient or cells responds poorly to the effect of insulin Net effect will be high level of blood glucose 8. PATIENT WITH CARDINAL SIGNS OF DIABETES Polydipsia Polyurea Polyphagia Weightloss Poor wound healing Severe infections Obesity Weakness 9. General complications Ketoacidosis Hyperosmolar nonketotic coma (type 2 diabetes) Diabetic retinopathy/blindness Diabetic nephropathy/renal failure Accelerated atherosclerosis (coronary heart disease ) Ulceration and gangrene of feet Diabetic neuropathy Infections 10. Diabetic gangrene of the feet. 11. Oral complications of poorly controlled diabetes mellitus XEROSTOMIA BURNING SENS Continue reading >>
[tooth Extraction On Diabetic Patients].
Abstract Performing extractions on diabetic patients is a complicated problem, which is connected with the type of diabetes and the various complications related to this disease. The main concern is to avoid acute incidents hyper or sub-glycemic comas during the operation and to secure a smooth post- operational course, namely an undisturbed post- extracture healing. In this study, 80 diabetic patients who came for extractions to the escodental department were divided into two categories: patients suffering from diabetes type I and patients suffering from diabetes type II. On the arrival of all patients, the contents of glycose in blood and acetone in urine were measured, and depending on the respective results patients of the first category were classified into three groups and patients of the second category were classified into four groups. Along with the normal measures usually taken for diabetic patients, specific instructions were given for the groups of each category, in order to prevent hyper- or sub-glycaminate incidents, during the operation. Proper instructions were further given for those patients, who had history chronical complications from diabetes. Extractions based on th method of classifying the patients into the above mentioned categories and groups have presented no complications whatever in our study. Continue reading >>
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Post-extraction Wound Healing In Patients With Type 2 Diabetes (pewhpd)
The purpose of this study is to evaluate clinical healing after dental extraction and the occurrence of surgical complications in patients with type 2 diabetes and compare with non-diabetic patients or control, taking into account laboratory data such as blood count, glycated hemoglobin (HbA1) and immunological profile of the patients. It has been established in scientific literature that patients with diabetes have a greater predisposition to oral complications and that oral infections may compromise their metabolic control. There is scant clinical evidence of a relationship between diabetes and an increased risk of infection after dental extractions. To our knowledge, no prospective longitudinal studies have been designed to prove this hypothesis. The aim of this study is to evaluate clinical healing after dental extraction and the occurrence of surgical complications in patients with type 1 and 2 diabetes and compare with non-diabetic patients, taking into account laboratory data such as blood count, glycated hemoglobin (HbA1) and immunological profile of the patients. Ninety patients shall be prospectively studied, divided into 3 groups: Group 1 will consist of 30 patients with uncontrolled type 2 diabetics patients, group 2 will consist of 30 controlled type 2 diabetics patients and group 3 composed of 30 non-diabetic patients (control group). All patients will undergo extraction of erupted teeth, always carried out by the same dentist (MS). A complete medical history and laboratory tests will be conducted for all patients including: glycated hemoglobin (HbA1), fasting glucose, complete blood count, platelets, prothrombin time (PT), partial thromboplastin time (PTT), immunoglobulins (IgA, IgG and IgM), CD3, CD4, CD8, testing of complement (C3, C4), dihydrorhodamine Continue reading >>
What Is The Recommended Blood Glucose Level For Tooth Removal?
In hospital dental practice (while dealing with high risk patients), the main rule that is followed is, in cases of an uncontrolled medical condition, all elective procedures should be avoided. On the other note, in the same patient, any emergent condition that can be life-changing or life threatening must be performed as soon as possible while simultaneously treating the uncontrolled condition. As an oral and maxillofacial surgeon, we have had to do extractions in patients with their blood glucose levels > 300 mg/100ml! This became necessary because the tooth was the cause of serious fascial space infection in that patient. The patient was being intensively treated for controlling his diabetes and removal of the foci of infection can also help in his glycemic control as infective states can worsen glycemic control. The main issue of blood sugar is not during the extraction procedure, but what may happen after the procedure during the healing period as in delayed wound healing, dry socket or even osteomyelitis. Co existing conditions in a diabetic (like hypertension) may affect the outcome. The mere increased blood glucose levels are not a risk factor during the procedure. They tolerate the procedure well but in the post extraction period, some complications may be anticipated. Meticulous management of these complications can help avoid issues. Also, in most uncontrolled diabetics, the problem tooth requiring extraction is usually periodontally compromised and mobile. A uncontrolled diabetic who is on oral hypoglycemic agents will require about 2 weeks before he is reassessed when his glycemic status will be deemed to be in control. In this two weeks, the patient may need to be on prolonged medications (antibiotics, analgesics etc;) and that can have additional complica Continue reading >>
Diabetes And Dental Complications
It has long been known that having diabetes increases the risk of severe periodontal disease. For example, people with poorly controlled type 2 diabetes are more likely to develop periodontal disease than those with well-controlled diabetes. Studies have found that poorly controlled diabetes respond differently to bacterial plaque at the gum line than do people with well-controlled diabetes and people without the disease. Also, people with poorly controlled diabetes have more harmful proteins (cytokines) in their gingival tissue, causing destructive inflammation of the gums. In turn, beneficial proteins (growth factors) are reduced, interfering with the healing response to infection. Lastly, people with diabetes tend to lose collagen, a protein that supports gums, skin, tendon cartilage, and bone, in their gum tissue, thus hastening periodontal destruction. Vascular disorders (caused by diabetes), such as reduced circulation in tiny blood vessels in the gums, interfere with nutrition and healing in the gum tissues. Young people with type 1 diabetes, especially those with poor control, are very vulnerable to early-onset periodontal disease as they reach puberty. Studies on Diabetes and Dental Problems A study published in the September 2002 issue of Diabetes Research and Clinical Practice looked at 102 patients, average age 65 with type 2 diabetes. In this Swedish study, the researchers conducted a comprehensive dental examination and then compared these results with the same battery of tests given to a control group without diabetes but otherwise the same in terms of age and gender. The results indicate that subjects with diabetes had more pockets between teeth, which indicate moderate to advanced gum disease. They also had deeper pockets. The group with diabetes had mo Continue reading >>
Diabetes
Diabetes mellitus is a group of metabolic diseases that lead to high levels of blood glucose (hyperglycemia), which is caused when the body does not make any or enough insulin, or does not use insulin well. Because diabetes is a relatively common condition, practicing dentists are likely to encounter it frequently. Type 1 diabetes is a chronic autoimmune disease in which the beta cells in the pancreas create little to no insulin, and accounts for 5% to 10% of all diabetes cases. In contrast, Type 2 diabetes accounts for 85% to 90% or more of diabetes cases and is one of the commonest chronic diseases, characterized by decreased response of target tissues to insulin, dysregulation of insulin production, or a combination of both. As with any patient, the dentist should review the patients medical history, take vital signs, and evaluate for oral signs and symptoms of inadequately controlled diabetes, which may be common. Oral manifestations of uncontrolled diabetes can include: xerostomia; burning sensation in the mouth; impaired/delayed wound healing; increased incidence and severity of infections; secondary infection with candidiasis; parotid salivary gland enlargement; gingivitis; and/or periodontitis. Although patients with diabetes usually recognize signs and symptoms of hypoglycemia and self-intervene before changes in or loss of consciousness occurs, staff should be trained to recognize the signs and treat patients who have hypoglycemia. In such cases, a glucometer should be used to test patient blood glucose levels, and every dental office should have a protocol for managing hypoglycemia in both conscious and unconscious patients. Diabetes mellitus is a group of metabolic diseases that leads to high levels of blood glucose and is caused when the body does not make Continue reading >>
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