the patient’s blood glucose level with a glucometer and administering a high-carbohydrate food or glucagon. In the case of severe hypoglycemia or hyperglycemia, the dental professional should be prepared to contact emergency medical services and have the patient transferred to a hospital. The dental office should have a diabetic emergency kit and train its entire staff to be prepared to respond to medical emergencies. In the past, the dental team may not have played a significant role in the shared management of a patient with diabetes. However, recent findings suggest that the dental team can make a substantial contribution to the shared care of diabetes through regular liaison with the patient’s team of medical providers and diabetes specialists. An interdisciplinary collaboration of management and treatment among dental and medical professionals ultimately results in the optimal overall treatment of patients, and this is especially true with patients with diabetes. Madianos, P. N., & Koromantzos, P. A. (2018). An update of the evidence on the potential impact of periodontal therapy on diabetes outcomes. Journal of clinical periodontology, 45(2), 188–195. https://doi. org/10.1111/jcpe.12836 Marieb, E. N., & Hoehn, K. (2019). Human anatomy & physiology (11th ed.). Pearson Education.Miller, W. D. (1891). The human mouth as a focus of infection. The Lancet, 138 (3546), 340-342. https://doi.org/10.1016/ S0140-6736(02)01387-9. Miller, A., & Ouanounou, A. (2020). Diagnosis, Management, and Dental Considerations for the Diabetic Patient. Journal (Canadian Dental Association) , 86 , k8. Naiff, P., Carneiro, V., & Guimaraes, M. (2018). Review article: Importance of mechanical periodontal therapy in patients with diabetes type 2 and periodontitis. International Journal of Dentistry. Nazir, M. A., AlGhamdi, L., AlKadi, M., AlBeajan, N., AlRashoudi, L., & AlHussan, M. (2018). The burden of Diabetes, Its Oral Complications and Their Prevention and Management. Open access Macedonian journal of medical sciences , 6 (8), 1545–1553. https://doi.org/10.3889/ oamjms.2018.294 Oyapero, A., Adeniyi, A. A., Sofola, O., & Ogbera, O. A. (2019). Effect of glycemic control on periodontal disease and caries experience in diabetic patients: A pilot study. Journal of Interdisciplinary Dentistry , 9 (3), 99. https://doi.org/10.4103/jid.jid_67_18 Patton, L. L., & Glick, M. (2015). The Ada Practical Guide to Patients with Medical Conditions, 2nd Edition (2nd ed.). John Wiley & Sons. Acta Odontologica Scandinavica, 21 , 533-551. Perez-Losada, F. L., Jane-Salas, E., Sabater-Recolons, M. M., Estrugo-Devesa, A., Segura- Egea, J. J., & Lopez-Lopez, J. (2016). Correlation between periodontal disease management and metabolic control of type 2 diabetes mellitus. A systematic literature review. Medicina Oral Patología Oral y Cirugia Bucal, 21 (4), e440-446. https://doi.org/10.4317/medoral.21048 Rani, L. S., Dharman, S., & Maragathavalli, G. (2019). Assessment of Diabetic Status in Denture Stomatitis and Angular Cheilitis Patients in a University Hospital Setting - A Retrospective Analysis. International Journal of Dentistry and Oral Science , 4 (2), 36–41. https://doi.org/10.19070/2377-8075Rathinavelu, S., Guidry-Elizondo, C., & Banu, J. (2018). Molecular modulation of osteoblasts and osteoclasts in type 2 diabetes. Journal of Diabetes Research. Revankar, S. G. (2019). Antifungal Drugs . Merck Manuals. https://www.merckmanuals.com/professional/ infectious-diseases/fungi/antifungal-drugs. Rohani, B. (2019). Oral manifestations in patients with diabetes mellitus. World Journal of Diabetes , 10 (9), 485–489. https://doi.org/10.4239/wjd.v10.i9.485 Sarkar, S., & Donner, T. (2020). Autoantibodies in Type 1 Diabetes. In Johns Hopkins Diabetes Guide Shaikh, M. S., Alnazzawi, A., Habib, S. R., Lone, M. A., & Zafar, M. S. (2021). Therapeutic Role of NystatinAdded to Tissue Conditioners for Treating Denture-Induced Stomatitis: A Systematic Review. Prosthesis , 3 (1), 61–74. https://doi.org/10.3390/prosthesis3010007 Shi, J., Fan, J., Su, Q., & Yang, Z. (2019). Cytokines and Abnormal Glucose and Lipid Metabolism. Frontiers in endocrinology , 10 , 703. https://doi.org/10.3389/fendo.2019.00703 Shutoff, K. K., & Boyd, L. D. (2018, May 18). Oral Health Care for Patients With Diabetes . Decisions in Dentistry. https://decisionsindentistry. com/article/oral-health-care-patients- diabetes/. Singh, M., Bains, V. K., Jhingran, R., Srivastava, R., Madan, R., Maurya, S. C., & Rizvi, I. (2019). Prevalence of Periodontal Disease in Type 2 Diabetes Mellitus Patients: A Cross- sectional Study. Contemporary Clinical Dentistry , 10 (2), 349–357. https://doi.org/10.4103/ccd.ccd_652_18 Solis-Herrera, C., Triplitt, C., Reasner, C., DeFronzo, R. A., & Cersosimo, E. (2018). Classification of Diabetes Mellitus. In K. R. Feingold (Eds.) et al., Endotext . MDText.com, Inc. Son, S.-H., & Lee, E.-S. (2018). Effects of Periodontal Treatment on Glycated Hemoglobin A Levels in Patients with Type 2 Diabetes: A Meta-Analysis of Randomized Clinical Trials. Journal of Dental Hygiene Science , 18 (3), 137–146. https://doi.org/10.17135/jdhs.2018.18.3.137 Susanto, A., Manurung, A. S. A., Miranda, A., & Sopiatin, S. (2020). Periodontal disease and treatment needs among patients with diabetes mellitus Type 2 attending Talaga Bodas Community Health Center in Bandung City. Scientific Dental Journal , 4 (1), 1–5. https://doi.org/10.4103/sdj.sdj_27_19 Vesna, A. (2018). Connection between the Periodontal Disease and Diabetes Mellitus. Interventions in Obesity & Diabetes , 1 (5). https://doi.org/10.31031/iod.2018.01.000521 Wang, X., Wang, H., Zhang, T., Cai, L., Kong, C., & He, J. (2020). Current Knowledge Regarding the Interaction Between Oral Bone Metabolic Disorders and Diabetes Mellitus. Frontiers in Endocrinology , 11 . https://doi.org/10.3389/ fendo.2020.00536 Wynn, R. L., Meiller, T. F., & Crossley, H. L. (2019). Drug information handbook for dentistry: including oral medicine for medically compromised patients & specific oral conditions (25th ed.). Wolters Kluwer. Xiao, E., Mattos, M., Vieira, G., Chen, S., Corrêa, J. D., Wu, Y., Albiero, M. L., Bittinger, K., & Graves, D. T. (2017). Diabetes Enhances IL-17 Expression and Alters the Oral Microbiome to Increase Its Pathogenicity. Cell host & microbe , 22 (1), 120–128.e4. https://doi.org/10.1016/j.chom.2017.06.014Zhang, Y., He, J., He, B., Huang, R., & Li, M. (2019). Effect of tobacco on periodontal disease and oral cancer. Tobacco induced diseases , 17 , 40. https://doi.org/10.18332/tid/10618
xerostomia (dry mouth) and oral candidiasis, a condition of fungal infection that is exacerbated by xerostomia and dentures. Dental treatment considerations for patients with diabetes include conducting a full review of the patient’s medical history, determining the presence of diabetes, evaluating glycemic control, scheduling early morning appointments, encouraging patients to eat normally before dental appointments, and ensuring proper glycemic control following dental procedures that affect eating. The dental professional must also carefully evaluate the periodontal health of patients with diabetes and be aware of potential adverse reactions between patients’ hypoglycemic medications and adjunctive dental treatment medications. Dental professionals must be prepared to recognize the signs of diabetic emergencies – including hypoglycemia and hyperglycemia – and address them during dental treatment. Measures for treating hypoglycemia include assessing Acharya, A. B., Thakur, S., Muddapur, M. V., & Kulkarni, R. D. (2016). Tumor necrosis factor- a, interleukin-4 and -6 in the serum of health, chronic periodontitis, and type 2 diabetes mellitus. Journal of Indian Society of Periodontology , 20(5), 509. https://doi.org/10.4103/0972-124x.201694 Agarwal, R., & Baid, R. (2017). Periodontitis and diabetes: A bidirectional, cyclical relationship - A brief review. Acta Medica International , 4 (2), 46. https://doi.org/10.4103/ami.ami_16_17 American Academy of Periodontology. (2021). Periodontal Disease Fact Sheet . Perio.org. https://www.perio. org/newsroom/periodontal-disease-fact-sheet. American Dental Association. (2019). Diabetes . ada.org. https://www.ada.org/en/member- center/oral-health- topics/diabetes. American Dental Association. (2019). Xerostomia (Dry Mouth). ada.org. https://www.ada.org/en/member- center/oral-health-topics/xerostomia. American Dental Association. (2019). Oral-Systemic Health . ada.org. https://www.ada.org/en/member- center/oral-health-topics/oral-systemic-health. American Diabetes Association. (2018). Statistics About Diabetes . diabetes.org. http://www.diabetes.org/diabetes-basics/statistics/. References Asadipooya, K., & Uy, E. M. (2019). Advanced Glycation End Products (AGEs), Receptor for AGEs, Diabetes, and Bone: Review of the Literature. Journal of the Endocrine Society , 3(10), 1799–1818. https://doi. org/10.1210/js.2019-00160 Bera, R., Ray, A., Ghorui, T., & Bandyopadhyay, R. (2020). Dental Considerations for Patients with Diabetes Mellitus. IOSR Journal of Dental and Medical Sciences , 19(6), 07–14. https://doi.org/10.9790/0853- 1906140714 Brutsaert, E. F. (2020). Diabetes Mellitus (DM) . Merck Manuals Professional Edition. https://www. merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes- mellitus-and-disorders-of- carbohydrate-metabolism/diabetes-mellitus-dm. Centers for Disease Control and Prevention. (2019, May 30). Type 2 Diabetes . Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/type2.html. Centers for Disease Control and Prevention. (2020). National Diabetes Statistics Report, 2020. Estimates of Diabetes and Its Burden in the United States . Centers for Disease Control and Prevention. https://cdn1.digitellinc.com/uploads/nachc/articles/dca110a5ca25cb95b43fa4d5cc3f244f.PDF. Duda-Sobczak, A., Zozulinska-Ziolkiewicz, D., & Wyganowska-Swiatkowska, M. (2018). Type 1 Diabetes and Periodontal Health. Clinical Therapeutics , 40 (6), 823–827. https://doi.org/10.1016/j. clinthera.2018.01.011 Duran-Merino, D., Molina-Frechero, N., Castañeda-Castaneira, E., Gaona, E., Reyes-Reyes, R. E., Tremillo Maldonado, O., … Bologna-Molina, R. (2017). Relationship between Periodontal Disease and Type 1 Diabetes in Adolescents. Annals of Medical and Health Sciences Research , 7 , 350–354. Fenn, S. M., Narayanan, M., & Jacob, M. (2019). Prevalence of oral Candida in saliva of uncontrolled and controlled type 2 diabetes mellitus patients – Beyond reasonable doubt? SRM Journal of Research in Dental Sciences , 10 (1), 1. https://doi.org/10.4103/srmjrds.srmjrds_48_18 Franco, M. M., Moraes, M. M., Duarte, P. M., Napimoga, M. H., & Benatti, B. B. (2017). Glycemic control and the production of cytokines in diabetic patients with chronic periodontal disease. RGO - Revista Gaúcha De Odontologia , 65 (1), 37–43. https://doi.org/10.1590/1981- 863720170001000063063 Graziani, F., Gennai, S., Solini, A., & Petrini, M. (2018). A systematic review and a meta- analysis of epidemiologic observational evidence on the effect of periodontitis on diabetes: An update of the EFP- AAP review. Journal of Clinical Periodontology, 45 (2), 167-187. Harvard Health Publishing. (2018). Type 2 Diabetes Mellitus . Harvard Health. https://www.health.harvard. edu/a_to_z/type-2-diabetes-mellitus-a-to-z. Ilea, A., Babtan, A. M., Bosca, B. A., Crisan, M., Petrescu, N. B., Collino, M., … Campian, R. S. (2018). Advanced glycation end products (AGEs) in oral pathology. Archives of Oral Biology, 93 , 22-30. International Diabetes Federation. (2020). Diabetes complications . International Diabetes Federation. https://www.idf.org/aboutdiabetes/complications.html. International Diabetes Federation. (2020). What is diabetes . International Diabetes Federation. https://www. idf.org/aboutdiabetes/what-is-diabetes.html. Joslin Diabetes Center. (2021). What is Gestational Diabetes? Joslin Diabetes Center. https://www.joslin.org/ patient-care/diabetes-education/diabetes-learning-center/what- gestational-diabetes#. Khan, T. (2018). Oral Manifestations and complications of diabetes mellitus: A review. International Journal of Medical and Health Research, 4( 2 ) , 50-52 Kumar, M., Agrawal, M. C., Rastogi, N., & Bajpai, M. (2017). Prosthodontic Management of Patients with Diabetes. Acta Biomedica Scientia , 4 (2), 75–77. Lima, D., Carneiro, S., Barbosa, F., Saintrain, M., Moizan, J., & Doucet, J. (2017). Salivary flow and xerostomia in older patients with type 2 diabetes mellitus. PloS one , 12 (8), e0180891. https://doi. org/10.1371/journal.pone.0180891Löe, H. (1967). The gingival index, the plaque index, and the retention index systems. Journal of Periodontology, 38 (Suppl.), 610-616. https://doi.org/10.1902/ jop.1967.38.6.610. Löe, H., & Silness, J. (1963). Periodontal disease in pregnancy: I. Prevalence and severity.
DIABETES: DENTAL MANAGEMENT AND LINKS TO PERIODONTAL DISEASE, UPDATED EDITION Final Examination Questions Select the best answer for each question complete your test online at EliteLearning.com/Book
150. A characteristic of type 1 diabetes is:
152. Which statement is most accurate regarding type 2 diabetes? a. Between 5% and 10% of all cases of diabetes involve type 2 diabetes. b. Type 2 Diabetes occurs predominantly in children and young adults. c. The etiology of type 2 diabetes involves an autoimmune destruction of the cells of the pancreas. d. Treatment options for type 2 diabetes include weight loss and increased physical activity.
a. A dependence on exogenous insulin. b. A gradual and insidious onset.
c. Associated obesity. d. Insulin resistance. 151. Approximately 90% to 95% of patients with diabetes have:
a. Type 1 diabetes. b. Type 2 diabetes. c. Type 3 diabetes. d. Gestational diabetes.
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