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As with all diabetic complications, an ounce of prevention is worth its weight in gold. By far the most important step that can be taken is to brush and floss regularly. It is advisable to discuss proper brushing and flossing techniques with your dental team. Some of the fundamentals might surprise you. For example, it is recommended that you brush for a minimum of three minutes, which, when put into practice, is longer than one might imagine.
In the Chair
Prevention also includes making and keeping the often-dreaded dental appointment. See the dentist twice a year, or as often as necessary. If you are avoiding the dentist due to fear and or loathing, there are some strategies to make it a little easier to deal with.
It is best to schedule dental appointments, about an hour and a half after breakfast so that the appointment does not interfere with regular meal times. Test your BGs before you go to the dentist and test them while you are at the dentist’s office. Make sure to stick to your regular insulin and/or oral medication schedule to avoid BG problems. It is also important to discuss your diabetes with your dental team.
The dental team needs to know if their patients take oral agents or insulin because that means special precautions must be taken. Dentists caring for patients with diabetes should have a calibrated glucose meter, glucose tablets or fruit juice, and a glucagons kit available.
They should also be familiar with the common signs of hypoglycemia such as loss of coordination, blurry vision, palpitations, rapid heart rate, sweating and shaking. They must also know if a patient with diabetes has hypoglycemic unawareness, a condition in which they experience few if any signs and symptoms of low blood sugars.
A common situation leading to hypoglycemia at the dental office is a patient skipping breakfast before an appointment but taking the regular amount of insulin.
Severe hyperglycemia may occur as well, but less frequently. Acetone breath and dehydration dry mucous membranes and changes in mental status are signs that blood glucose is too high and dental procedures should be postponed.
The relationship between diabetes and periodontal disease is well established. Preventive oral health care, including professional cleanings at the dental office, is important if you are to control the progression of periodontal disease and other oral health problems.
The key thing to remember is that diabetes can cause additional problems so those with diabetes need to take additional care to keep their teeth and gums healthy.