Question

CRITICAL THINKING QUESTION #3 A dental assistant initially examines a teenager who has recently been diagnosed with diabetes, has had insulin prescribed, and wonders why his gums seem dry and sore. His physician recommends that the patient rest more to reduce future complications, but he feels that the patient's glucose levels are under control. In what physical classification is this patient? How will the dental assistant schedule him for his follow-up restorative appointments, modify his dental treatment, and discuss certain dental health recommendations with him and his guardians?

Answer 1

The patient is on Type 1 diabetes which is an autoimmune disorder occur mostly in young children. The beta cells of the pancreas secrete inadequate insulin to circulate the blood glucose level to all over the body. Insulin has to be administered for this patient to meet the demand and to control the blood glucose level. Diabetes usually increases the susceptibility of dental disease. So improving and controlling of the oral disease improves the glycemic control.

The dentist should analyze the past medical history of this patient, diabetes-associated complications, HbA1c level, insulin type, duration, and dosage, food intake, and dryness and soreness of the mouth. Dental health appointments should be scheduled based on insulin therapy and the activity. Usually, the appointments are scheduled in the morning where the cortisol level is higher which reduces the risk of hypoglycemia. Before initiating the treatment, the dentist must confirm the food and medication intake. The dentist should discuss with the physician about adjusting of insulin therapy post to the procedure as the oral intake become poor. He should assess the signs and symptoms of hypoglycemia. He should discuss with the parents about oral hygiene, the importance of glycemic control, and oral intake.