Diabetes and Dentistry: Relationships and Care

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Diabetes is a systemic disease characterized by high blood glucose levels as a result of failure to secrete or act on insulin, a hormone produced by the pancreas. Essential for the absorption of glucose by cells, insulin, when absent or ineffective, leads to the accumulation of glucose in the blood, causing hyperglycemia. There are several types of diabetes, such as type 1, type 2 and gestational, that affect more than 8% of the Brazilian population.

Diabetic patients have a high risk of facing oral problems due to lack of glycemic control and interference with saliva production, making them more susceptible to infections. Complications such as gingivitis, periodontitis, bone and tooth loss are common, in addition to difficulties in healing, which means risks in gum surgeries and treatments. Therefore, it is essential to choose a responsible and attentive dental professional to perform a thorough history and clinical examination. Some patients are already aware of the condition, while others are not.

Signs such as increased acidity and viscosity of saliva, hypoplasia, dry mouth, mouth ulcers, and ketone breath are common. The dentist should request laboratory tests in case of suspicion or family history. Once diagnosed, the patient must be under medical care, monitored by an endocrinologist, to authorize dental procedures.

A patient is considered “compensated” when blood glucose levels are controlled, a necessary condition for dental procedures, as control of bacterial infection is crucial in diabetes. During the treatment, the dentist must take some precautions

Schedule sessions in the morning, period when insulin secretion is maximum;

Limit the duration of sessions to avoid stress and the risks of hypoglycemia;

Ensure that the patient is adequately fed;

Use specific anesthetics, such as mepivacaine 3% without vasoconstrictor or prilocaine with phenylephrine;

Be prepared to manage episodes of hypoglycemia by offering the patient something with sugar if necessary.

For patients, it is essential to intensify daily oral hygiene and regular visits to the dentist. Diabetes control is possible and oral health depends on this care. The dentist has the role of treating the patient holistically, enabling him to recognize, diagnose and treat the oral symptoms associated with diabetes.