ersons with diabetes should be evaluated by their physician before scheduling treatment for periodontal disease. The dental practitioner should also consult the physician before gum surgery to be aware of the patient's general condition. Knowledge of the patient's medical history helps the dentist and physician determine the need for pretreatment with antibiotics. The decision whether or not to pre-treat with antibiotics should be based on the special needs of each patient and the type of dental procedure planned.
ACUTE INFECTIONS:
Surgical treatment of advanced periodontal disease should be deferred in favor of conservative nonsurgical therapy, including adjunctive use of antibiotics, until diabetes is reasonably controlled. Acute infections, however, require immediate attention, including draining acute abscesses and administering broad-spectrum antibiotics. Complete metabolic control of diabetes may not be possible while dental infection is still present. However, if blood glucose can be reduced, the acute periodontal infection may improve.
ORAL SURGERY:
Once infection has subsided, necessary tooth extractions or other treatment can be performed. When diabetes is under good control, oral surgery can be carried out as in a nondiabetic patient. Dental appointments should be scheduled in
the morning, generally about an hour and a half after breakfast and the morning insulin. Persons with more severe diabetes should have surgery in a hospital where they can be
more easily monitored during and after the procedure.
From the National Institute of Dental and Craniofacial Research
Detection and Prevention of Periodontal Disease in Diabetes
June 1994
http://www.nohic.nidcr.nih.gov/pubs/perdiab/treat/index.html
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