DENTAL MANAGEMENT OF DIABETIC PATIENTS

ORAL MANIFESTATION OF DIABETES MELLITUS:-
THE ORAL MANIFESTATIONS OR COMPLICATIONS OF UNCONTROLLED DIABETES MELLITUS INCLUDE:
XEROSTOMIA
PAROTID GLAND ENLARGEMENT
ORAL CANDIDIASIS
PROGRESSIVE PERIODONTITIS
BURNING MOUTH
ALTERED TASTE
INCREASED CARIES RATE
ORAL NEUROPATHIES
PERIAPICAL ABCESSES
THE ORAL FINDINGS IN PATIENTS WITH UNCONTROLLED DIABETES ARE MOST LIKELY RELATED TO THE FOLLOWING FACTORS:
1.THE EXCESSIVE LOSS OF FLUID THROUGH FREQUENT AND EXCESSIVE URINATION
2.ALTERED RESPONSE TO INFECTION
3.THE MICROVASCULAR CHANGES
4. THE INCREASED CONCENTRATIONS OF GLUCOSE IN SALIVA.
XEROSTOMIA IN DIABETES
XEROSTOMIA OR DRY MOUTH CAN LEAD TO CRACKING AND ATROPHY OF THE ORAL MUCOSA.
MUCOSITIS , ULCER FORMATION, DESQUAMATION, INCREASED LIKELIHOOD OF BACTERIAL AND FUNGAL INFECTIONAND DEPAPILATION OF THE DORSUM OF THE TONGUEARE COMMONLY ENCOUNTERED INUNCONTROLLED DIABETIC PATIENTS.
XEROSTOMIA MAY ALSO PREDISPOSE TO ACCUMULATION OF DENTAL PLAQUE AND CONTRIBUTE TO PERIODONTAL DISEASE AND CARIES.
BURNING MOUTH AND ALTERED TASTE IN DIABETES
MAY BE DUE TO DIABETIC NEUROPATHY.
PERIODONTAL DISEASE AND DENTAL CARIES IN DIABETES
DECREASED COLLAGEN SYNTHESIS
INCREASED COLLAGENOUS ACTIVITY
DECREASED BONE MINERAL CONTENT (IN IDDM)
SECONDARY HYPOPARATHYROIDISM DUE TO DIABETIC NEPHROPATHY.
DEFECTIVE POLYMORPHONUCLEAR LEUKOCYTES CHEMOTOXINS.
EACH OF THESE FACTORS COULD RESULT IN ACCELERATED ALVEOLR BONE DESTRUCTION.
DENTAL CARIES IN DIABETIC PATIENTS IS RELATED TO THE INCREASED LEVELS OF GLUCOSE IN SALIVA AND CREVICULAR FLUID.