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A Trip to the Dentist
It should be clear by now; regular dental care is of extreme importance to people with diabetes. Regardless of your health condition you should see your dentist at least twice yearly for an examination and routine cleaning.
If you have any other conditions, including tooth decay or periodontal disease, you should see your dentist more frequently. Defeat Diabetes Foundation Executive Director, Andrew P. Mandell, actually has his teeth examined and cleaned four times yearly!
There is also no doubt that a trip to the dentist isnít generally associated with a lot of pleasure, so itís the kind of thing people can find reasons to put off until itís too late.
How to choose a dentist if you have diabetes
If you havenít visited the dentist for a few years, you can either schedule an appointment with your old dentist or, if youíve moved or changed insurance policies, you might want to schedule an appointment with someone new.
A good dental team, particularly for people with diabetes, is important. Finding the right dental-care provider will take some time and research, and it is best done before an emergency arises. So, start your search well before youíre due for a checkup.
Things to consider when making your selection include:
An obvious place to begin your search is to ask your friends.
The American Dental Association (ADA) or a state dental association is another way of finding
a dentist. These individuals have made a commitment to their profession by joining these associations.
Your doctor, Certified Diabetes Educator or pharmacist may also have a list of dentists who work with people who have diabetes.
Compare your list to the list of providers with whom your insurance company does business. Thereís no point in finding a great dentist who doesnít take your insurance.
After youíve narrowed down your list, hit the Internet. Many dentists also have websites which will give you information on where they went to school, how long theyíve been in practice, the types of services they offer, if they attend regular conferences or have continuing education, what their treatment philosophy is, types of anesthesia they are licensed to use, even pictures of their office and facilities.
When you call a dentistís office, does the receptionist sound professional and courteous? Ask if they are accepting new patients and ask if they have experience working with patients who have diabetes? Are they able to answer your questions? If they seem reluctant to answer your questions that could be a sign of potential trouble in the future; best to move on to your
When you schedule your appointment be sure to ask what their cancellation policy is. If you do have to cancel your appointment be sure to do it in the appropriate time frame or you may be charged Ė not a good way to start a relationship!
If you have an allergy to latex, mention it when you make the appointment so the office can prepare for your visit.
Your First Appointment with a New DentistYour first appointment with a new dentist should be a comprehensive oral exam. This is an in-depth exam that enables the dentist to develop a treatment plan for you. This is a good time to evaluate a dentistís ďchair side mannerĒ and make sure that this dentist is right for you.
Take note of the equipment used in the office. Dentists who use older equipment and techniques can provide excellent care, but the latest technology, can make checkups faster, less painful, and more thorough.
The dentist should provide you with intake forms that record your medical and dental history. This may include information about your previous dental work, any medical conditions or illnesses you have (or had), medicines you take and allergies you have.
Be sure to tell them you have diabetes, how long youíve had it, how you control it, your current A1C level, as well as problems (dental or physical) youíve had recently. Your dental team should follow up on these issues every visit.
Your dentist should have your physician's name and phone number so they can contact your physician with any concerns or questions about your treatment.
The dentist will then give you a complete oral exam, checking the interior of your mouth, testing your salivary glands, your tongue and examining each tooth for cavities, periodontal disease and mobility. They should also give you a complete cleaning and a few, or a full, set of x-rays (you can save yourself a bit of money if you bring x-rays, two years old or less, to your
The dentist may immediately see a few things which should be taken care of in a priority manner. Either way, the dentist will develop a treatment plan for you and spend some time explaining the plan, how long it will take and how much it will cost.
Even if the treatment plan is extensive, slacking off on your dental care is a sure fire way to lose teeth. Donít make that mistake. Most dentists are willing to work with you on some sort of payment plan (with or without insurance) to help insure your dental health.
If, however, after your initial visit you donít like your dentist, the office or anything else, then seek another candidate. Going to the dentist is hard enough for most people. Going somewhere you donít like the people or the environment makes it even more difficult.
Another option, for those who truly canít afford dental care, is to pursue treatment at a local dental school. Dental schools are always seeking real life patients, though the process can be a bit cumbersome and more time consuming than a trip to the regular dentist. Many of the procedures are one-third to one-half the cost of a regular dentist. All of the procedures are overseen by professors who also have regular dental practices.
Preparing for a regular appointment
People with diabetes have to take some special precautions before going to a dental appointment. 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. Stick to your regular insulin and/or oral medication schedule to help minimize blood glucose problems. Test your blood glucose level before you go to the dentist and test again at the dentistís office, just before they begin the procedure.
Dental therapy for people with diabetes does not have established criteria. Although dental offices record medical conditions, such as diabetes, they may not be prepared for an emergency resulting from diabetes, so be sure to take your ďtravel kitĒ with you. The basics include your meds, testing supplies, glucose tabs and juice or quick carbohydrate should you experience any lows. This is important because the target blood sugar level for good control has been lowered to 126 mg/dl, which increases the chance of hypoglycemic episodes.
If you've had a hypoglycemic episode in the past, you are at increased risk to have another one. Be sure to tell your dentist when the last one was and how common they are. 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.
Most hypoglycemic episodes will occur when your insulin peaks, so make sure your dentist knows when you last took insulin.
Some medications your dentist might use can also interfere with some oral medications prescribed for diabetes. This makes it even more important that your dentist know the medications you are taking and the dosage and to notify him of any changes in your prescription regimen.
Before treatment update your dentist on any changes in your physical or oral health and report any abnormality, such as gingival bleeding.
Follow your dentist's post-treatment instructions, thoroughly and precisely. People with diabetes tend to be slower to heal and more prone to infection, so do whatever you can to help yourself recover completely. After treatment, resume your normal diet immediately. If this is not possible, seek advice from your doctor.
Some people with poorly controlled diabetes, or those with cardiovascular and/or kidney complications, may need a course of antibiotics before and after any dental treatment, such as surgery, that might put them at risk for a bacterial infection.
Special Note: People with diabetes who are having orthodontic work done need to contact their orthodontist immediately if a wire or bracket is cutting into their tongue or mouth. These can develop into sores and be a conduit for a more serious bacteriological infection. People with intraoral appliances made of acrylic (night guards) may also have an increased risk
If your dentist is treating a periodontal infection, you may need to visit your physician to have your insulin dose calibrated.
Updated April 5, 2013
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