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 dentist’s 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 “travel kit” 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 for candidiasis.
If your dentist is treating a periodontal infection, you may need to visit your physician to have your insulin dose calibrated.