Diabetes Mellitus and Prosthodontic Care Chanchal Katariya & Dr. Sangeetha
Diabetes Mellitus and Prosthodontic Care Chanchal Katariya & Dr. Sangeetha
294
International Journal of Multidisciplinary Research and Modern Education (IJMRME)
Impact Factor: 6.725, ISSN (Online): 2454 - 6119
(www.rdmodernresearch.org) Volume 3, Issue 1, 2017
Increased Risk of Fungal Infection:
Fungal infections like candidiasis is associated with poor glycemic control and use of denture. It is due
to Change in pH, increased salivary glucose levels and immune dysregulation in diabetic patients.
Burning Sensation:
In diabetes, burning mouth syndrome, which develops due to peripheral neuropathy, causes
xerostomia, candidiasis and taste disturbance in the mouth. These adversely affect the patient’s food intake and
create a negative effect on metabolic control of diabetes.
Increased Caries Risk:
Patients with diabetes mellitus have increased risk of caries and periodontal problems. As there is
change in the oral environment due to decreased salivary flow and pH and increased pathogenic bacterial
growth in the mouth causes damage to the hard and soft tissue of the teeth.
Prosthodontic Care in Diabetes Mellitus:
The restoration and the maintenance of good oral hygiene is mandatory before starting any
prosthodontic procedures.
Medical History: It is important to take proper medical history of the patient’s Blood glucose levels,
Medication, dosage and timing of medication taken. Make sure the patient had donetheir blood glucose
level test prior to the treatment.HbA1C is evaluated to check overall glycemic control for a period of 3
months.It is very important to evaluate proper medical history and assess glucose level at the initial
appointments in all the patients older than 45 years of age.
Diet: It should be ensured that patient has had his/her breakfast and medication before treatment.
Scheduling of the Patient’s Visit: Diabetic patients should be scheduled preferably in the morning.
Since endogenous cortisol level is higher during morning time which in turn increases blood glucose
level
In RPD: All components of RPD must be designed appropriately such that prosthesis is tissue friendly.
Proper oral hygiene and denture hygiene or maintenance instructions should be given to the patients.
In CD: Denture border and tissue surfaces of the dentures should be smooth without any sharp nodules
or over extensions to prevent tissue damage.Impressions should be taken in mucostatic technique
without pressure. Concept of neutal zone technique can be employed to reduce the bone resorption
.Proper oral hygiene instructions can be given to patients to avoid fungal infections.As there is decrease
denture retentiondue to less salivation, frequent sipping of water and use of sugarless gums may help
them to maintain salivary flow.
In FPD: It is better to keep the finish line supragingival to avoid damaging soft tissue. The chamfer
margin is a better option as it applies less force or stress on weakened tooth.Ante's law should be
obeyed as the diabetic patient more prone for periodontal infection.Proper flossing should be done to
maintain the oral hygiene. During tooth preparation, care should be taken to avoid trauma to the soft
tissue as diabetes patients have poor wound healing. Hygienic pontic should be preferred as much as
possible for ease of cleansing action.
In Implant or Implant Supported Dentures: Implant supported prosthesis are not indicated for
uncontrolled diabetic patients but if conditions are favorable, then this type of prosthesis can be
planned.Proper medication must be provided before and after implant placement. Patient should
maintain their sugar level even after the surgical placement of implants.
Conclusion:
Diabetes is a common metabolic disorder associated with hyperglycemia and its complications.
Management of diabetic dental patient should focus on general oral health & the delivery of comprehensive
dental care with minimal disruption of metabolic homeostasis.Its important to give a proper prosthodontic care
to diabetes patient inspite of the complications they posses.Good oral&denture hygiene maintenance and proper
dental check up is a pre requisite for ensuring the long term successful Prosthodontics treatment.
References:
1. Lamster IB, Lalla E, Borgnakke WS, Taylor GW.The relationship between oral health and diabetes
mellitus.The Journal of the American Dental Association. 2008 Oct 31;139:19S-24S.
2. Daniel R, Gokulanathan S, Shanmugasundaram N, Lakshmigandhan M, Kavin T. Diabetes and
periodontal disease. J Pharm BioallSci 2012;4, Suppl S2:280-2
3. Kansal G, Goyal D. Prosthodontic Management Of Patients With Diabetes Mellitus. J Adv Med Dent
Scie Res 2013;1(1):38-44.
4. Consultation, W. H. O. "Definition, diagnosis and classification of diabetes mellitus and its
complications." (1999): 25.
5. Mealey BL. Diabetes and periodontal disease: two sides of a coin. CompendContinEduc Dent.
2000;21:943-6, 948, 950.
6. Chang PC, Lim LP. Interrelationships of periodontitis and diabetes: A review of the current literature.
Journal of Dental Sciences. 2012 Sep 30;7(3):272-82.
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International Journal of Multidisciplinary Research and Modern Education (IJMRME)
Impact Factor: 6.725, ISSN (Online): 2454 - 6119
(www.rdmodernresearch.org) Volume 3, Issue 1, 2017
7. Bascones-Martinez A, Matesanz-Perez P, Escribano-Bermejo M, González-Moles MÁ, Bascones-
Ilundain J, Meurman JH.Periodontal disease and diabetes-Review of the Literature.Med Oral Patol Oral
Cir Bucal. 2011 Sep 1;16(6):e722-9.
8. Gibran NS, Jang YC, Isik FF, Greenhalgh DG, Muffley LA, Underwood RA, Usui ML, Larsen J,
Smith DG, Bunnett N, Ansel JC. Diminished neuropeptide levels contribute to the impaired cutaneous
healing response associated with diabetes mellitus. Journal of Surgical Research. 2002 Nov
1;108(1):122-8.
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