According to the IDF 2017 Global Diabetes Map (8th edition), there are 114.4 million people with diabetes in China, almost one in ten, yet, according to scientific estimates, nearly half of the people with diabetes in China are undiagnosed, and dentistry is, in turn, an important window for detecting diabetes. window.
How is diabetes related to periodontitis?
Can diabetics have their teeth extracted?
What do diabetics need to know about tooth extraction if they have to?
It’s amazing how dentistry has become an important window for detecting diabetes
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It’s not uncommon to meet people who don’t eat their main meal at dinner parties, is it? In addition to those on a diet, another big possibility is high blood sugar.
According to the IDF (International Diabetes Federation)2017 Global Diabetes Map (8th edition), there are 114.4 million people with diabetes in China, almost one in ten, and I was shocked to see this number for the first time, not realizing the problem was so serious.
Diabetes is mainly a problem with the body’s handling of sugar, mainly in the form of elevated blood sugar and urine sugar.
High blood sugar, insulin, and “keep your mouth shut and your legs open” are all familiar keywords for diabetes, but what does diabetes have to do with tooth extraction?
Lao Zhang is 55 years old and has always been in good health, but in the past few years he has felt that he has some problems with his teeth, he can’t chew beef and his teeth are a bit swollen from time to time, but he didn’t take it seriously and thought it was a “fire” until one day he noticed that his big teeth were moving a bit, so he took it seriously and went to the dentist.
The doctor diagnosed him with severe periodontitis, and the bone around the tooth was almost destroyed by resorption, and several of them had to be extracted.
The doctor did not start pulling teeth right away, but instructed Zhang to go to the hospital to check his blood sugar first.
The company is still wondering what a dental visit has to do with blood sugar. The company’s main goal is to provide the best possible service to its customers. The company’s main goal is to provide the best possible service to its customers.
This is what I’m talking about. According to scientific estimates, nearly half of all diabetics in China are undiagnosed, and dentistry is an important line of defense in detecting diabetes because diabetes and periodontal disease are very closely related, and diabetes often manifests itself in the teeth, and the dentist is often the “first person” to detect it. The dentist is often the “first person” to detect diabetes.
How does diabetes become associated with periodontitis? Simply put, the mechanism of periodontitis is that bacterial stimulation activates the immune response in the toothbed, and the excessive immune response destroys the bone around the teeth, causing the gums to recede and the teeth to loosen.
And many of the immune responses in people with diabetes are also abnormal, exacerbating the destruction of periodontal tissue. According to a large epidemiological survey,people with diabetes have a 2.9 times higher risk of periodontitis than healthy people, and diabetes increases the risk of alveolar bone destruction by 11 times.
So when a dentist sees some middle-aged patient in the clinic with periodontal disease that is not proportional to the severity of oral hygiene, and if that patient is also a little chubby (obesity is also a high risk factor for diabetes), he or she is advised to check the blood sugar.
Stable control of blood glucose below 8.8 mol/L 2 hours after meal before extraction
Then, in Zhang’s case, several teeth were so badly damaged that they could no longer be retained and had to be extracted as soon as possible to get rid of the lesion.
But when he found the maxillofacial surgeon who extracted the teeth, he took a look at the medical records and did not extract the teeth right away, asking him to provide a recent fasting blood glucose or glycated hemoglobin lab slip, and if he didn’t have one, he needed to check one before extracting the teeth.
Because these two indicators can help the doctor determine how well the patient’s blood glucose is controlled. If the blood glucose has been relatively stable, then the damage caused by diabetes is actually more limited, and it is perfectly acceptable for all kinds of dental treatment, including tooth extraction procedures. However, if the blood sugar is not well controlled, the long-term hyperglycemic state can change the texture and blood supply of the alveolar bone and gums, and if a tooth is rashly extracted, complications such as excessive bleeding and non-healing wounds may occur.
Patients with diabetes are at a much higher risk of subsequent wound infection due to high blood glucose, which is conducive to germ propagation, and once this causes a wound infection, it can easily develop into an interstitial or deep tissue infection, with the oral cavity adjacent to the maxillary sinus and further up the cranial cavity, and if the infection spreads to the cranial cavity, it can lead to meningitis or sepsis, which can be life-threatening and very dangerous.
So, If you want to have a tooth extraction, it’s best to keep your blood glucose stable at less than 8.8mmol/L two hours after a meal or a glycated hemoglobin of less than 8%.
Keep your mouth clean after tooth extraction as prescribed
Also, make sure not to hide your diabetic condition from your dentist. To prevent post-operative bleeding and infection and to allow the wound to heal as quickly as possible, the dentist should also choose a more minimally invasive approach when performing the extraction and will decide whether to give post-operative anti-infective medication depending on the procedure.
So if you are diagnosed with diabetes, it is important to have regular dental checkups to maintain good periodontal and dental health, and a healthy periodontal status will in turn promote better diabetes.
If you have to have a tooth extraction, keep your blood glucose at a relatively low level through diet, exercise and medication to reduce the risk of surgery,The indicators are also very good to remember: three 8s, less than 8.8 two hours after a meal, and glycated hemoglobin less than 8% (this value may also vary from hospital to hospital). (this value may also vary from hospital to hospital).
After extraction, follow medical advice to avoid interference with wound healing, use anti-infective medications and mouthwash as appropriate to keep the mouth clean. And continue to keep your blood sugar stable during recovery. If there is severe discomfort or swelling in the wound, or if you develop a fever, be sure to seek prompt medical attention to control the spread of infection.
