THE DIABETIC PATIENT IN THE DENTAL CLINIC: CARE AND TREATMENT GUIDELINES

Abstract

Introduction: Diabetes mellitus, a group of metabolic diseases, is becoming increasingly more common among the world population, and consequently being considered a public health issue. Diabetes may showearly signs in the oral cavity, predisposing patients to various oral diseases. Knowledge of the disease is important for the correct management and treatment of these patients. Objective: To propose a protocol of dental care and management for diabetic patients. Development: During anamnesis of medical history, gather information about the disease: type, time since diagnosis, medications, systemic and oral manifestations, history of hypoglycemic/hyperglycemic crisis. During physical examination, verify vital signs,body mass index, and intra-oral soft tissues, as well as complete theodontogram and periodontal chart. Glycated hemoglobin of previously diagnosed patients should be evaluated, and patients at risk should be referred to their physician. On the day of treatment, patients should be instructed as to eat and take their medications. Visits should be short and early in the morning, and glucose should be checked beforethe patient is treated. Patients with controlled glucose levels do not require antibiotic prophylaxis and may receive anesthetics with vasoconstrictor. In case of a hypoglycemia episode, one must try to control it before it becomes a medical emergency. Conclusion: With clinical and complementary examination, collect as much information about the disease as possible to classify the degree of risk that treatment may pose to the patient. Compensated patients do not require differential dental treatment. Decompensated patients should not undergo any elective treatment and should be treated accordingly. DESCRIPTORS: Diabetes Mellitus. Dentistry. OralHealth. Primary Health Care.