Diabetes mellitus is a condition that is characterized by high blood glucose levels. It has two types, 1 Type 1 or diabetes mellitus (T1DM) is caused mainly by an auto-immunological destruction of the pancreatic β cells which are responsible to produce insulin, but it can be caused by other factors. The patients that suffer from T1DM have a total deficiency of insulin, and are usually young. In type 2 or diabetes mellitus (T2DM), different cells of the body including fat and muscle cells develop a resistant to the actions of insulin. This induces β cells to secrete more insulin, but the overproduction of insulin is not enough to keep blood glucose levels inside a normal physiological range. Out of all the diabetes cases reported worldwide,
…show more content…
The most distinct ones are fruity-acetone breath, polyuria, polydipsia, and polyphagia. This will help determine if an undiagnosed diabetic condition is present or if the patient is at a higher risk of developing diabetes. In case any evidence if found that suggest diabetes, the patient if referral to the physician for evaluation. On the other hand, if the dental hygienist is treating a patient that knows about his or her diabetic status, the health history assessment should include: type of diabetes, method of disease control, medications schedule and dosages, last A1C results and date, frequency of glucose monitoring and of last reading, date of the last hypoglycemia episode, and any other question that can help with the assessment. In case the patient is has poor glycemic control, the patient is referral to the physician, and nutritional counseling is recommended. It is imperative to help patient to control glucose levels before doing any therapeutic scaling and periodontal debridement. A patient with uncontrolled diabetes has a higher risk for dental caries due to the reduction of saliva (xerostomia) and increased glucose in saliva; are prone to infection like candidiasis and have poor wound healing capacity. Older patients might present kidney complications, blindness, hypertension and other systemic diseases. There is not contraindication with patients that have controlled diabetes. For patients that need local anesthetic agents, the minimal use of vasoconstrictors is required since epinephrine can raise the glucose level in the blood. For uncontrolled diabetes patients, prophylactic antibiotic premedication should be considered before periodontal instrumentation. As part of treatment, fluoride application is indicated to reduce the risk of caries, nutrition counseling is recommended due to patient’s constant need
The most distinct ones are fruity-acetone breath, polyuria, polydipsia, and polyphagia. This will help determine if an undiagnosed diabetic condition is present or if the patient is at a higher risk of developing diabetes. In case any evidence if found that suggest diabetes, the patient if referral to the physician for evaluation. On the other hand, if the dental hygienist is treating a patient that knows about his or her diabetic status, the health history assessment should include: type of diabetes, method of disease control, medications schedule and dosages, last A1C results and date, frequency of glucose monitoring and of last reading, date of the last hypoglycemia episode, and any other question that can help with the assessment. In case the patient is has poor glycemic control, the patient is referral to the physician, and nutritional counseling is recommended. It is imperative to help patient to control glucose levels before doing any therapeutic scaling and periodontal debridement. A patient with uncontrolled diabetes has a higher risk for dental caries due to the reduction of saliva (xerostomia) and increased glucose in saliva; are prone to infection like candidiasis and have poor wound healing capacity. Older patients might present kidney complications, blindness, hypertension and other systemic diseases. There is not contraindication with patients that have controlled diabetes. For patients that need local anesthetic agents, the minimal use of vasoconstrictors is required since epinephrine can raise the glucose level in the blood. For uncontrolled diabetes patients, prophylactic antibiotic premedication should be considered before periodontal instrumentation. As part of treatment, fluoride application is indicated to reduce the risk of caries, nutrition counseling is recommended due to patient’s constant need