Dental management of the diabetic patient

1. Non-insulin dependent patient: all dental procedures can be performed, no special precautions are needed unless complications of diabetes are present.
2. Insulin-controlled patient: Usually all dental procedures can be performed, morning appointments are usually best. Advise pt to take usual insulin dosage and normal meals on day of dental appointment; confirm when pt comes for appointment. Advise the pt to inform you or your staff if symptoms of insulin reaction occur during the dental visit and have a source of glucose (orange juice, glucola) available and give it to pt if symptoms of insulin reaction occur.
3. Extensive surgery needed: consult with physician concerning dietary needs during postoperative period. Consider prophylactic antibiotics for pt with brittle diabetes (the opposite of tightly controlled) or one taking high doses of insulin to prevent postoperative infection.
4. Special precautions may be needed for pt with complications of diabetes, renal disease, heart disease, etc.

Category: Pharmacology Notes