DIABETOLOGY
High risk
- Significantly decompensated DM1 and DM2
- With glycaemia above 15 mmol/l or HB A1c above 75 mmol/mol
Medium risk
-
Type 1 diabetic with comorbidity:
- after cardio-vascular episode
- with nephropathy
- after cardiac surgery
Low risk
- G Well compensated diabetic
A statement of a diabetologist to dental treatment for an inflammatory focus should be given to a diabetic patient who has an Hb A1c higher than 75 mmol/mol, which the dentist will determine by the diabetic patient's chart. A glycaemia above 15 mmol/l is risky but should always be taken into account it may be caused by stress during a dental examination or treatment.
Periodontitis and other dental infections lead to decompensation of diabetes and successful treatment of infection improves Hb A1c by up to 10 mmol/mol. Therefore, dental infections in the diabetic patient must be managed consistently. In addition, the presence of dental foci exacerbates the atherogenicity of diabetes.
In prediabetics, the presence of an inflammatory focus predicts the development of type 2 diabetes.
Both type 1 and type 2 diabetic patients have a higher risk of infection – before a dental procedure, there is no reason for primary antibiotic pre-treatment but:
- if antibiotic indication is borderline after the procedure, it is appropriate to proceed with antibiotic treatment
- check patients after the procedure for infectious focus early and actively look for progression of infection and do not delay antibiotic treatment if signs of infection are present.
DM1 - Diabetes Mellitus Type 1
DM2 - Diabetes Mellitus Type 2
HB A1c - Glycated haemoglobin
Periodontitis and other dental infections lead to decompensation of diabetes and successful treatment of infection improves Hb A1c by up to 10 mmol/mol. Therefore, dental infections in the diabetic patient must be managed consistently. In addition, the presence of dental foci exacerbates the atherogenicity of diabetes.
In prediabetics, the presence of an inflammatory focus predicts the development of type 2 diabetes.
Both type 1 and type 2 diabetic patients have a higher risk of infection – before a dental procedure, there is no reason for primary antibiotic pre-treatment but:
- if antibiotic indication is borderline after the procedure, it is appropriate to proceed with antibiotic treatment
- check patients after the procedure for infectious focus early and actively look for progression of infection and do not delay antibiotic treatment if signs of infection are present.
DM1 - Diabetes Mellitus Type 1
DM2 - Diabetes Mellitus Type 2
HB A1c - Glycated haemoglobin