Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Review

Volume 10, Number 2, February 2018, pages 77-81

Orthodontic Treatment Consideration in Diabetic Patients

Tables

Table 1. Dental Complications of Diabetes Mellitus
 
1Mouth dryness and burning (xerostomia)
2Oral acetone smells in poorly controlled patients
3Brittle teeth
4Dental caries
5Recurrent oral infections, e.g. oral candida
6Mouth ulcerations
7Altered taste sensation
8Delayed healing of mucous membranes
9Teeth disposition and misalignment
10Periodontitis
11Gingivitis

 

Table 2. Pathophysiology of Dental Complications of Diabetes
 
Proposed mechanismPathophysiology and impacts
Diabetic microangiopathySmall and medium sized vessel angiopathy
Decline blood flow to dental structure
Ischemic tooth ache
Tenderness of gum
Bone erosions
Teeth loss
Polymorphic dysfunctionRecurrent oral ulcers
Protein metabolism impairmentCollagen breakdown and delayed healing

 

Table 3. Summary of Orthodontic Consideration in Diabetic Patients
 
Considerations before deciding orthodontic treatmentEnsure good oral hygiene and dental health (most potent)
Tight control of diabetes
Exclude periodontitis
Monitor blood glucose before going into active orthodontic treatment
Considerations during the process of orthodontic treatmentApply light physiological forces
Antibiotic prophylaxis before: orthodontic bed placement; separator placement; screw insertion
Antibiotic prophylaxis is not needed in: simple adjustment of appliances; simple replacement of appliances
Considerations to prevent or manage emergencies during the process (especially hypoglycemia)Morning meal on day of orthodontic treatment
If symptoms of hypoglycemia occurred: IV dextrose; IM glucagon 1 mg