Gaining An Overview Of Your PWD · 2) Do you know if you have Type 1 or Type 2 diabetes? 3) When...
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Gaining An Overview Of Your PWD Once identified upon a review of the medical history: 1) How long ago were you diagnosed? 2) Do you know if you have Type 1 or Type 2 diabetes? 3) When was the last time you visited your physician? 4) What type of diabetes medication(s) do you take and how do you take them (oral, injection, insulin pump)? 5) Do you know when your last HbA1c was taken and the result? 6) Did you test your BG today, and at what time? Results? 7) Did you bring your BG testing kit with you today? 8) Do you wear a continuous glucose monitor? 9) When was the last time you ate something? 10) Blood Pressure is taken.
Transcript of Gaining An Overview Of Your PWD · 2) Do you know if you have Type 1 or Type 2 diabetes? 3) When...
GainingAnOverviewOfYourPWD
Onceidentifieduponareviewofthemedicalhistory:1) Howlongagowereyoudiagnosed?2) DoyouknowifyouhaveType1orType2diabetes?3) Whenwasthe lasttimeyouvisited yourphysician?4) Whattypeofdiabetesmedication(s) doyoutakeandhow
doyoutakethem(oral,injection, insulin pump)?5) DoyouknowwhenyourlastHbA1cwastakenandtheresult?6) DidyoutestyourBGtoday,andatwhattime?Results?7) DidyoubringyourBGtesting kitwithyoutoday?8) Doyouwearacontinuousglucosemonitor?9) Whenwasthe lasttimeyouatesomething?10)BloodPressure istaken.
PotentialDiabeticOfficeEmergenciesHypoglycemia(mostlikely)
• Coldclammyskin
• Sweating
• Confused/Dizzy
• Shaky/Nervous
• Irritable
• Hunger
• Unresponsive
• ConvulsionsAcuteAcute
PotentialDiabeticOfficeEmergenciesHypoglycemia(mostlikely)
• Coldclammyskin
• Sweating
• Confused/Dizzy
• Shaky/Nervous
• Irritable
• Hunger
• Unresponsive
• Convulsions
Hyperglycemia(notacute)
• Weakness
• Nauseaandvomiting
• Frequenturination
• Thirst
• Blurryvision
• Drymouth
• Shortness ofbreath
• Coma
AcuteAcute
ClinicalImplicationsOfTreatingPWD
• SchedulingConsiderations
• BloodGlucoseMonitoring
• CommonMedications-
ForManagingBG-(PotentialForLowBG)
Anti-hypertensives-Xerostomia,Hyperplasia
ClinicalImplicationsOfTreatingPWD
PeriodontalDiseaseDiabetes
• Educate,Educate,Educate
• KnowledgeofMostRecentA1C
• ReductionoftheBacterialBurdenviaScalingandRootPlaning- Antimicrobials?
• MaintenanceVisitsEvery3-4Months
• KnowtheLimitsofYourScopeofPractice!
Sandberg GE, etal.Acontrolled study of oralself-care and self-perceived oralhealthin type2diabetic patients. Acta Odontol Scand.2014;59:28-33.
.Gingivitis-• Redness• Puffiness• Bleeding• Probe Depth <3mm• No Recession
Lamster, I. . et al. JADA 2008;139:suppl 5:19S-24S
Copyright © 2013 American Dental Association. All rights reserved. Reproduction or republication strictly prohibited without prior written permission of the American Dental Association.
Clinical ImplicationsOfTreatingPWD
• Peri-Implantitis-Whentheaboveparametersarepresentwithanydegreeofdetectablebonelossfollowingtheinitialboneremodelingafterimplantplacement,adiagnosisofperi-implantitis ismade.
Bleedingonprobingand/orsuppuration,whichareusuallyassociatedwithprobingdepths≥4mmandnoevidenceofradiographiclossofbonebeyondboneremodeling.
• Peri-ImplantMucositis-
Javed F.,etal.Impactofdiabetesmellitusandglycemiccontrolontheosseointegration ofdentalimplants:asystematicliteraturereview.JPeriodontol. 2009Nov;80(11):1719-30.Marchand, F,Raskin,A,Dionnes-Hornes, Aetal.Dentalimplantsanddiabetes: conditions forsuccess.DiabetesMetab. 2012; 38:14–19.
CottrellDA.Etal.Dentalimplantplacementintype2diabetics:areviewoftheliterature.JMassDentSoc.2010Spring:59(1):12-14.
