What is diabetes?
According to the NIH, diabetes is a disease in which blood glucose, or blood sugar, levels are too high due to a problem with insulin.
How does diabetes affect the oral health of children?
Children with diabetes can be more prone to soft tissue abnormalities.
Oral manifestations of diabetes
- Periodontal disease (gums and bone around the teeth are affected)
- Gingivitis
- Reduced saliva
- Taste dysfunction
- Susceptible to fungal and bacterial infections
Dental Management and Prevention
Prevention is essential in managing the dental health of the child with diabetes. Scheduling the child for early professional dental examinations is recommended.
Tips for Proper Dental Hygiene
- Avoid treatment during or at insulin peaks in order to reduce risk of hypoglycemia.
- The child must eat normally and take medications as directed prior to appointment.
- Apply topical fluoride and visit the dentist every 6 months.
- Parents should begin brushing when the first baby tooth erupts and should assist their child in brushing until the child reaches 8 years of age.
- Use fluoridated toothpaste; for children under 3 years old use a smear amount of fluoridated toothpaste and for children above 4 years old use a pea size amount.
- Parents should monitor dietary practices (i.e. avoid prolonged use of bottle, reduce amounts of sugar consumed, reduce frequency of sugar consumed).
Preparing a child with Diabetes for a Dental Appointment
Discuss the medications currently being taken with the child's dentist. A thorough medical history and assessment of diabetes control should be completed by the dental provider. Morning appointments are advisable. Remember that the most important dental emergency to avoid in patients with diabetes is hypoglycemia.
Tatiana Toquica, DDS - Nicklaus Children's Pediatric Dentistry Residency Program
References
Mayer-Davis EJ, Lawrence JM, Dabelea D, et al. Incidence trends of type 1 and type 2 diabetes among youths, 2002-2012. N Engl J Med. 2017;376:1419-1429.
Murphy D, McCulloch CE, Lin F, et al. Trends in prevalence of chronic kidney disease in the United States. Ann Intern Med. 2016;165:473-481.
United States Renal Data System. 2016 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of Health;2016.
Quirino M, Birman E, Paula C. Oral Manifestations of Diabetes Mellitus in Controlled and Uncontrolled Patients. Braz Dent J 1995;6(2): 131-136.
Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2017. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2017.