Oral Surgery - Type 1 Diabetes - Diabetes Forums
Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. I'm getting ready to get my wisdom teeth out and my Dr said it will have to be an oral surgery. They're concerned about my sugars since I can't have anything to eat for bfast the day of. I'm a little worried about the anesthesia, I'm not sure if I need general or local or does it matter? I'm also worried about the healing process and what I can eat right after surgery. The surgery won't be until January but these are a few things that have been lingering in my head since my consultation. Does anyone have any advice, comments, pointers? How did you do after having your wisdom teeth taken out? This may sound like a stupid question but I've never had surgery so it's kind of scary. Just wondering, what should I expect? How are your basal rates? Have you ever basal tested? Do you KNOW what fasting will do to you? If yes to all, stay a little high but keep the pump on and don't worry about it. Surgery is fun ... I was awake for mine, but that was 25 years ago. You get amazing drugs. You won't mind it a bit. You are on a pump so consider it as a test of your basal insulin... if you have your basal(s) set correctly you should be able to fast without any problem. If not you might want to get them right before the surgery With that said, any oral surgery I have had, they preferred my BG to be a little higher than normal, as opposed to low. If your BG is generally well controlled, healing should be less of a concern. I'm getting ready to get my wisdom teeth out and my Dr said it will have to be an oral surgery. They're concerned about my sugars since I can't have anything to eat for bfast the day of. I' 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 >>
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 >>
Wisdom Teeth Removed - Any Advice?
My daughter who is 16 is having her wisdom teeth removed under general anesthesia. The doctor has advised to go easy on her tresiba to ensure shes not low during the surgery. Any other words of wisdom or things I should be aware of? Great question! My oldest (nonD) son got his removed yesterday. It was quick and uneventful - less than a half an hour. I thought about what I would do if Caleb needs to have his removed. I would definitely target a higher bg starting overnight bc of fasting instructions and keep a higher target until I am confident hes able to eat regularly. Id approach it similar to a stomach bug. Colin came home and had a milkshake, then pasta, then scrambled eggs and rice with a gelato chaser. All has gone well so far, knock wood. Good luck. Ill be watching for advice from those who have been under general anesthesia! And a reminder to check the expiration date on the glucagon the stuff is only good for a short period of time, and often times I have to set a reminder to go pick up another one otherwise Id forget since its not something that we generally use unless its an emergency situation. My 19 yr old had all 4 wisdom teeth removed last November. We lowered her basals at 5am. She went under at 8:15, with BG at 130. I gave the Dexcom to the surgeon (he was also administering anesthesia) & explained how to work it. Half an hour later they called me back to take her hom. BG was between 120 & 130 throughout. She did only liquids for 2 days (her choice). Lots of smoothies, soup & water. She did fine. A few lows into the 60s but nothing a little juice couldnt handle. When under General anesthesia the anesthesiologist should be checking the numbers with a Glucose meter! I would make sure they do that! Meters can be off by +/- 20. If her Dexcom hadnt been ac Continue reading >>
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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 >>
Oral Surgery And Diabetes
Member T1 since 1992, pumping since 2001! I'm getting ready to get my wisdom teeth out and my Dr said it will have to be an oral surgery. They're concerned about my sugars since I can't have anything to eat for bfast the day of. I'm a little worried about the anesthesia, I'm not sure if I need general or local or does it matter? I'm also worried about the healing process and what I can eat right after surgery. The surgery won't be until January but these are a few things that have been lingering in my head since my consultation. Does anyone have any advice, comments, pointers? How did you do after having your wisdom teeth taken out? They put me on a drip and and a sliding scale both went I was sedated and when I had a general. They will monitor you closely, they tested me every 15 mins. Member T1 since 1992, pumping since 2001! Ok, it may have sounded like a stupid question but I've never had surgery and I'm just kind of scared and worried. I'm sure they know what they're doing but I was just wanted to know what to expect when I went in. D.D. Family T1 for 72 years, here to help I agree with Jo, you will be watched and your blood sugar will be monitored. Be sure to ask if you can wear your pump during the surgery. If they say you cannot then be sure they have an IV set up that will provide you with your basal during the operation. They can use the same kind of insulin that you use in your pump and you can tell them the basal rate you want them to use. My son had three wisdom teeth removed when he was 18. That was 24 years ago. He is not diabetic but he was not put to sleep. Your surgeon might recommend your being asleep but if he does I do not think there will be a problem. You have been pumping for seven years and you know you can skip meals like when you check your b Continue reading >>
Insights On Controlling Blood Sugar In The Dentist’s Chair
According to the American Dental Association (ADA), people with diabetes are more prone to periodontitis, tooth decay, oral fungal infections, taste diminishment, gingivitis and delayed healing time than people without the disease. That’s because uncontrolled blood sugar levels can cause and worsen those symptoms and conditions. According to the ADA, sugary and starchy foods contribute to high glucose levels in saliva, which can wear down tooth enamel, causing decay and cavities. Periodontal disease, which affects the gums and bones that hold the teeth in place, occurs at higher rates among diabetics. Of course, those diseases often lead people with diabetes to the dentist chair, and it’s there that they must undertake a juggling act between blood sugar control and the after-effects of dentistry. For people with diabetes, maintaining control of blood sugar levels after oral surgery can be frustrating. What we eat and the amounts we eat can become dangerously limited. As a diabetic who has undergone four wisdom tooth extractions and six fillings within the past two years, I am constantly looking for better ways to maintain control over my blood sugar. Plan for the Unexpected It is very important to plan for delays or extra procedures. Last summer, to beat the midday rush, I scheduled a dental appointment for 8:30 a.m. I didn’t eat breakfast because I had experienced a bad reaction when I ate before a biopsy requiring a local anesthetic two weeks earlier. I reasoned that I would be out of the office by 10 a.m. and would be able to eat soon thereafter. When I arrived, I learned that my dentist was ill and that because the procedure could not wait, a substitute dentist would do the necessary work. I told him that I was a diabetic and requested that I have a few minute Continue reading >>
An 18-year-old Patient With Type 1 Diabetes Undergoing Surgery
Go to: DESCRIPTION of CASE An 18-year-old Caucasian male with type 1 diabetes presented to the emergency department complaining of severe left knee pain and swelling after sustaining a knee injury that occurred during a high school football match. Joint effusions were visible and palpable above the left knee, and there was significant loss of smooth motion of the knee, passively performed. Plain X rays showed no signs of fractures. The patient had had type 1 diabetes for six years, and his insulin regimen consisted of insulin glargine, 35 units at 8:00 p.m., and insulin lispro, 23 units at 8:00 a.m. and 16 units at 8:00 p.m. The patient had no apparent complications related to type 1 diabetes. On examination he was alert, his pulse was 76 bpm regular, and his blood pressure was 118/66 mm Hg. Recently, the patient had had frequent episodes of both hyperglycemia and hypoglycemia. However, he had never developed diabetic ketoacidosis (DKA). His recent HbA1c was 9.5%, demonstrating inadequate glycemic control. The patient was referred to an orthopedic surgeon, and arthroscopy was scheduled a few days later. A complex tear of the medial meniscus extending to the articular surfaces was diagnosed. Partial meniscectomy was recommended. (This procedure usually takes about one hour—nonetheless, the preoperative preparation for general anesthesia and the postoperative recovery may add several hours to this time.) When Would You Have This Patient Report to the Hospital? The Day before Surgery or the Morning of Surgery? This patient should be hospitalized no later than the evening before surgery, given his history of frequent episodes of hypo- and hyperglycemia and his poor glycemic control. This should allow for final optimization of glucose control before surgery. Ideally, frequ Continue reading >>
Does Healing After Oral Surgery Take Longer In People With Diabetes?
Healing after oral surgery may take longer for someone who has uncontrolled diabetes because the healing process may be hindered by poor blood flow to the treatment area. (Poor blood flow is often associated with people who have diabetes.) While oral infections are more common with people who have diabetes, a close watch of blood sugar levels and good dental care should reduce the possibility of problems after surgery. Yes, as a general rule, healing after oral surgery takes longer is diabetics. This is because all tissues need glucose (sugar) to provide them with the energy to maintain normal function. When tissue is injured as it is in oral surgery, the demands of healing tissues require even more glucose. In the diabetic (even Type II), the availability of the glucose is compromised. In addition, diabetics often have high blood pressure due to changes in small vessels with further complicates the healing process. Continue Learning about Diabetes and Oral Health Videos Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs. Continue reading >>
My Next Patient Is Diabetic: What Are The Implications For The Dental Treatment I Provide?
The information contained in this publication (the Content) is not intended to substitute for appropriate clinical training nor for consultation of complete reference sources. Contents are for educational purposes, and should not be considered as the rendering of medical services, training or advice for any matter whatsoever. Your use of the Content is entirely at your own risk. The CDA does not represent or warrant that the use or clinical application of the Content will result in a particular patient outcome. The Canadian Dental Association specifically assumes no liability or responsibility for recommendations or advice set-out in the Content (whether provided by the CDA, its staff, or third parties) or for any losses, damages or claims arising from the use of the Content, including any losses or damages arising from the clinical application of such content. All statements of opinion and supposed fact are published on the authority of the author who submits them and do not necessarily express the views of the Canadian Dental Association.The Canadian Dental Association is not responsible and assumes no liability for the accuracy, reliability or currency of the information provided by external sources. Users wishing to rely upon this information should consult directly with the source of the information. Unless otherwise specifically indicated, publication of an advertisement does not necessarily imply that the Canadian Dental Association agrees with or supports the claims therein and the naming of any organization, product or therapy in this publication does not imply Canadian Dental Association endorsement nor guarantee the quality, value or effectiveness of any product, service or method advertised by a sponsor. Furthermore, CDA is not responsible for typographical 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 And Oral Health
During the past 10 years, much research has been undertaken on the link between diabetes and periodontal disease. Periodontal disease is the sixth leading complication of diabetes. If you have been diagnosed with diabetes, you are 3 to 4 times more likely to develop periodontal disease, with a higher rate of more severe levels of bone loss and gum infection.1 What Is Diabetes?Diabetes is a serious disease in which the body does not produce or properly use insulin, a hormone needed to convert sugar, starches, and other foods into energy. Normally, insulin helps get sugar from the blood to the body's cells, where it is used for energy. When you have diabetes, your body has trouble making and/or using insulin, so your body does not get the fuel it needs and your blood sugar stays too high. High blood sugar sets off processes that can lead to complications, such as heart, kidney, and eye disease, or other serious problems.2,3 If you have been diagnosed with diabetes,you are 3 to 4 times more likely to develop periodontal disease. Are There Different Types of Diabetes?It is estimated that more than 20 million adults and children in the United States have some form of diabetes14 million having been diagnosed with the disease and 6 million being unaware they have it. There are different types of the disease: type 1, type 2, and gestational diabetes, as well as prediabetes. Most Americans (around 90%) who are diagnosed with diabetes have type 2 diabetes.2,3 What Is Periodontal Disease?Periodontal disease, or gum disease, is a bacterial infection of the gums, ligaments, and bone that support your teeth and hold them in the jaw. If left untreated, you may experience tooth loss. The main cause of periodontal disease is bacterial plaque, a sticky, colorless microbial film that con Continue reading >>
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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Wound Healing After Tooth Extraction In Individuals With Type 1 Diabetes Mellitus
You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Wound Healing After Tooth Extraction in Individuals With Type 1 Diabetes Mellitus The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. ClinicalTrials.gov Identifier: NCT02953249 Information provided by (Responsible Party): Marina Helena Cury Gallottini, University of Sao Paulo Top of Page Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information Dental treatment to individuals with diabetes mellitus, particularly type 1 diabetes (T1DM), has always represented a challenge to the dentist. The literature provides some scientific evidence showing that diabetes is a risk factor for the occurrence of oral opportunistic infections, abnormal bone metabolism and delay in tissue repair, but with varying degrees of evidence. Hyperglycemia, as well as diabetes, are known as risk factor for post-surgical infections, so maintaining the glycemic control in the postoperative period has been standard to health care. However, there are few studies on the impact of the glycemic control in the repair process after tooth extractions. And, to our knowledge, there aren't evidences that infections resulting from oral surgery are more frequent in individuals with diabetes or that the antibiotics prophylaxis is needed for these individuals before invasive dental procedures. Some prospective studies show that people with diabet Continue reading >>
Instructions for patients undergoing local anesthesia, nitrous oxide (laughing gas) sedation, oral (children and adult) anesthesia: You may have a light meal (oatmeal, cereal, toast with a small glass of juice) 2-4 hours before your scheduled appointment. For patients undergoing oral sedation, a friend or family member should accompany the patient to their appointment, stay in the doctors office during the procedure, escort the patient home and observe the patient for 24 hours. Instructions for intravenous (IV) sedation: Patients undergoing Intravenous (IV) Sedation should have nothing to eat or drink for 6-8 hours prior to their appointment. If your appointment is in the morning, please refrain from all meals and beverages after midnight. If your appointment is in the afternoon, please eat a light breakfast (cereal, oatmeal, toast with a glass of juice/coffee) 6 hours prior to your scheduled appointment. Patients should wear loose, comfortable clothing (workout pants/sweats pants/shorts, a short sleeved t-shirt and shoes without a heel) to your appointment and should get plenty of sleep the night before. Minors should always have a parent or legal guardian accompany them to their appointment. A friend or family member should accompany the patient to their appointment, stay in the doctors office during the procedure, escort the patient home and observe the patient for 24 hours. Daily/Routine Medications: Patients taking daily medications may take their medications at their normal times with a few small sips of water. Diabetic Patients undergoing Intravenous (IV) Sedation: Patients with Diabetes should attempt to schedule their appointments in the morning when possible. For Non-Insulin Dependent Diabetics undergoing Sedation: All oral agents (Metformin, Glipizide, Glybu Continue reading >>