Why is My Dentist Concerned with My Diabetes?

Author: Dr. David Dickerhoff, DDS, MAGD, FOCOI

Diabetes Mellitus is an absolute or relative insulin insufficiency caused either by a low output of insulin from the pancreas (type 1) or resistance of peripheral tissue to insulin (type 2). Well-controlled diabetics can live a long and uncomplicated life with proper management of lifestyle, diet and medications for both types. Type 2 diabetics are usually managed by diet regulation, weight reduction, oral agent therapy starting with Metformin (Glucophage) and sometimes injectable insulin as well. Diabetics are concerned with sugar metabolism in their bodies and allowing this energy supplying component to pass into their cells for appropriate use. Because this is the foundation for all other metabolism (carbohydrates, fats, and proteins), the diabetic patient is at risk for any number of systemic (whole body) diseases that can manifest with poor sugar metabolism control. As it pertains to the dental office, uncontrolled diabetes puts patients at risk for periodontal disease, which is the result of a loss of attachment of the tooth to the surrounding jaw structures. Continued loss of attachment can lead to tooth mobility and eventual loss.

The insidious nature of periodontal disease as attachment loss progresses is the deepening of pockets around the tooth that hide bacteria and bacterial by-products which cause bone destruction. That is why your hygienist is charting your attachment levels with a periodontal probe! Periodic radiographs aid in this diagnosis as well as the detection of any soft tissue changes such as redness or bleeding. Routine blood tests at your physicians office can also aid in diagnosis as well as advising of the proper management for the condition. Hemoglobin A1C is a test where your physician will advise you on your level of control on your diabetes.

At Spring Lake Dental Group take your diabetes control so seriously in both its detection and management, we have numerous goals in our treatment of our patient population.

  1. Avoid diabetic ketoacidosis, where your body turns to using alternative pathways so it can provide energy to your system
  2. Avoid hypoglycemia (low blood sugar)
  3. Optimize hemoglobin A1C (HgA1C) to levels below 6.5%
  4. Aggressive blood pressure control
  5. Avoiding diabetic complications

We do this routinely by screening all of our patients for hypertension and updating their medical histories at every appointment. Taking blood sugar levels from our diabetic patients when we are performing invasive procedures is required as well. When treating our highest risk patients, they are put on monitors, prophylactic supplemental oxygen and a record is kept of their blood pressure, mean arterial pressure, heart rate and blood oxygen levels. We have low blood sugar level monitoring kits and supplemental sugar tabs available for any patient suffering from low blood sugar.

Keeping your diabetes under strict control requires having a conversation with your dentist and hygienist on a regular basis. We, at Spring Lake Dental Group, always welcome and encourage those conversations!