Can Diabetes Patients Get Implants?
Diabetes is a disease that develops when the pancreas cannot produce enough insulin or cannot use the insulin it produces. There are two known types: Type 1 and Type 2. Both are characterized by inappropriately high blood sugar levels (hyperglycemia).
While the patient with Type 1 diabetes cannot produce the insulin hormone, Type 2 diabetics produce insulin but cannot use it properly. Approximately 90 percent of diabetic patients have Type 2 diabetes.
The causes of diabetes are multiple, and both genetic and environmental factors contribute to this development. Genetic predisposition is very strong in type 2 diabetes, and it is known that various environmental factors such as nutrition, sedentary lifestyle and being overweight increase a person's risk of diabetes.
Oral symptoms are devastating in patients with uncontrolled diabetes. The most common oral findings are gum diseases accompanied by osteoporosis and inflammatory gingival changes. In addition, a decrease in saliva, deterioration in the functions of the salivary glands, an increase in bacterial, viral and fungal infections, recurrent abscesses, tooth loss, taste disorders, etc. are observed.
Gum diseases are accepted as the 6th Complication of Diabetes. The person's resistance to various diseases has decreased.
The important points for the dentist are;
First of all, it is to reach the most appropriate blood-glucose level. Fasting blood sugar should be below 90 mg/dl in healthy people, and postprandial blood sugar should be below 140 mg/dl in healthy people at 2 hours. These patients are considered to be in a low-risk group. Any type of dental treatment can be performed provided that the specified principles are followed. In some clinics, the dentist can perform this measurement himself from the patient's fingertip. HgA1c (hemoglobin a one c), also known as the three-month blood sugar measurement, is also an important follow-up criterion.
In patients with higher blood sugar levels but partially under control (including those who have not adjusted their medication or diet very well), many treatments can generally be performed with the physician's choice. However, in patients with many complications of diabetes, who occasionally experience coma, it is necessary to start treatments after diabetes is under control.
In order to reduce stress in patients, the dentist should generally schedule appointments in the morning, especially 1-2 hours after breakfast and medication intake. In addition, treatments are planned to be painless under anesthesia. Anesthetic drugs that do not contain adrenaline are used specifically, so that blood sugar does not increase.
Following the hygiene rules that should be standard in clinics will greatly contribute to the protection of diabetic patients who are prone to infection. Antibiotic application is recommended especially in people who cannot control it.
If surgical procedures are planned for diabetic patients (implants, tooth extractions, apical resection, impacted tooth extraction, etc.), a good tartar cleaning should be done before the procedure, oral hygiene training should be given, trauma and excessive force should be avoided during the procedures, and vitamin B and C supplements should be given if necessary.
As a result; in patients who have received good medical care and whose diabetes is under control, dental treatments, including implants, can usually be easily performed. However, depending on the difficulty level of the procedures to be performed, the dentist can consult with the doctor who monitors the patient's diabetes, and the treatment plan can be changed if necessary.
