Dental Care and Treatment of Children with Diabetes Mellitus - An Overview

Abstract

Dental management is of diabetic children aimed at implementation of a preventive protocol, symptomatic relief of any oral manifestations of the disease and immediate provision of primary care. Appointments should be short, stress free and a traumatic as possible. Early morning appointments are preferred and patient should eat normal breakfast before appointment to prevent hypoglycemia. Conscious sedation preferred than deep sedation. Insulin regimens should be adjusted by the diabetologist. Use of pulp capping and pulpotomy procedures in primary teeth is questionable in children with uncontrolled diabetes but vital pulptherapy may be preferred to a stressful extraction procedure under local anesthesia. In a non-vital tooth with evidence of infection, extraction is the only treatment of choice. Fixed or removable orthodontic appliance may be ideal, depending on the periodontal health of the patient. Prophylactic antibiotics may recommend before surgical procedure. Vasoconstrictor drugs with local anesthesia to ensure profound anesthesia are advocated, but excessive adrenaline dosage is contracted to prevent an increase in blood glucose levels and for this reason glucocorticosteriods should be avoided. This article discusses about overview of the pathophysiology an signs, symptoms, diagnosis and treatment of diabetes as well as dental treatment considerations for the children with diabetes.