Dental Management

For patients with known diabetes, questions related to each individual’s diabetes regime, difficulties they may be experiencing related to diabetes, results of their last medical visit, changes in their medication, and their compliance are essential to begin to formulate a dental plan. Because of the increased risk of hypertension, a blood pressure reading should be obtained (Table 1). A thorough oral examination will provide additional facts for creating a plan towards a healthful and preventive environment for the patient with diabetes. A comprehensive periodontal examination which includes an annual circumferential probing of all teeth, tracking clinical attachment loss, bleeding and exudate on probing, mobility and furcation involvement and a full mouth set of periapical radiographs, complete dental charting, and a treatment plan will supplement the findings. To start treatment, random blood glucose values should be between 70-200 mg/dL. Most glucometers will provide a reading of the blood glucose level in seconds. Requesting the patient to bring their blood glucose monitoring system and obtain a blood glucose value prior to treatment is imperative. Relying on the patient’s memory to provide an accurate value is risky. Some patients may be too embarrassed or unwilling to share high blood glucose values and may modify the true number.