Glycemic control & periodontal disease 1. Periodontal infection → adversely affect glycemic control ركسلا دوز 2. Periodontal treatment by subgingival mechanical debridement & antibiotics eliminate subgingival pathogen & suppress collagenase production → (Improve glycemic control ) ✓ Dental Management of a Diabetic Patient - Uncontrolled patients should be referred to the physician before any dental procedure - Management of Controlled patients 1. Dental appointments should be in morning about 1-2 h after breakfast & after usual insulin dose 2. Premedication: sedative or tranquilizer to decrease the endogenous adrenaline 3. Avoid long appointments 4. Antibiotic cover when surgery is indicated 5. Avoid Excessive trauma during surgical procedure 6. Local anesthesia with adrenaline (VC is essential to decrease pain) 7. Remove all septic foci and maintain good oral hygiene 8. Hospitalization is carried out if a. Multiple extraction is required b. Massive infection is present - This method depends on lifespan of RBCs (which are around 3-4 months) - Hemoglobin binds to glucose normally by 7%, more than that is diabetic. Home Blood Glucose Monitoring Urine test
