Contents & Outline

Diabetes, Clinical Dentistry and Changing Paradigms

Battling and Insidious Foe
A Challenge for Dentists 
A Biology of Complexity
Types of diabetes
Identifying those at risk
How Diabetes Occurs
IDDM 
Treating IDDM 
NIDDM
Criteria for Impaired Glucose Tolerance 
Treating NIDDM
Other treatments for NIDDM
Promoting Health, Preventing The Disease
Conclusion
For Additional Information

Oral Complications in Diabetes

Summary
Caries (Tooth Decay)
Periodontal Disease
Figure 1. Prevalence of Periodontal Disease in IDDM
Patients, by Age
Figure 2. Periodontal Attachment Loss in IDDM Patients and Nondiabetic Persons 
Figure 3. Periodontal Attachment Loss According to Retinal
Changes in IDDM Patients and Nondiabetic Persons
Figure 4. Severity of Periodontal Disease Among Diabetic and Nondiabetic Pima Indians
Figure 5. Distribution of Interproximal Alveolar Bone Loss in Diabetic and Nondiabetic Persons
Table 1. Incidence of Periodontal Disease in Pima Indians by Diabetes Status
Saliva
Other Pathological Features of the Oral Cavity
References

Oral Opportunistic Infections: Links to Systemic Diseases

bulletDiabetes Mellitus
bulletPreterm Low Birth Weight Babies
bulletTable 1. Oral Manifestations of Common Secondary Causes of Diabetes
bulletTable 2. Oral Manifestations of Other Autoimmune Diseases That May Coexist With Type 1 Diabetes
bulletDiseases Associated With Diabetes

Detection and Prevention of Periodontal Disease in Diabetes

bulletOverview
bulletGingivitis
bulletThrush
bulletPathophysiology
bulletProgress of Periodontal Disease
bulletDiabetic Control
bulletOral Factors
bulletNatural Dentition
bulletOral Hygiene
bulletAcute Infections
bulletOral Surgery
bulletDiabetes Control
bulletRisk of Infection
bulletReferences

Oral Complications of Diabetes: A Guide for Dental Hygienists

bulletOral Complications
bulletDental Management
bulletDiabetic Emergencies
bulletThe Role of Diet
bulletPlanning Dental Treatment
bulletDental Tips for Patients With Diabetes

Oral Complications of Diabetes: A Guide for Patients

What is the relationship between poor oral health and diabetes?
What is the link between diabetes and periodontal disease?
Diabetic Control
Blood Vessel Changes
Bacteria
Smoking
Controlled Diabetics Have New Reason to Smile
How does periodontal disease develop?
Gingivitis
Periodontitis
How is periodontal disease treated?
Plaque Removal
Periodontal Surgery
Since I have diabetes, do I need to do anything to prepare for oral surgery?
Are other oral problems linked to diabetes?
Dental Cavities
Thrush
Dry Mouth
Keep your teeth
How can you protect your teeth and gums?
Check Your Work
Dental Checkups
Things to keep in mind

Post-Test

Learning Objectives

After completing the course, you’ll be able to:

  1. Describe the epidemiology of diabetes mellitus in the U.S. particularly in minority populations.

  2. Describe the morbidity and mortality of diabetes.

  3. Explain the importance of glycemic control in a diabetic patient.

  4. Describe the etiology and pathogenesis of Type I (IDDM) diabetes.

  5. Describe the etiology and pathogenesis of Type 2 diabetes.

  6. Describe the long-term complications of diabetes.

  7. Explain the genetics of diabetes.

  8. Explain the interrelationship between glycemic control and periodontitis.

  9. Make the genetic connection between the increased risk for periodontitis and diabetes.

  10. Explain the pathophysiological mechanism involved in the destruction of collagen, accelerated alveolar bone loss and diabetes.

  11. Evaluate direct and indirect evidence considering diabetes as a risk factor for periodontal health.

  12. Compare the effect of mechanical periodontal treatment and systemic antibiotics therapy in improving periodontal status as well as glycemic control.

  13. Describe the connection between diabetes and oral health in older adults.

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link between diabetes and periodontal disease

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how the disease develops

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how it is treated

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other health problems linked to diabetes

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how to protect teeth and gums

  1. Provide patient teaching in the following areas:

  2. Describe the connection between bacterial infections and diabetes.

  3. List various microorganisms that are risk indicators for periodontitis in diabetic patients.

  4. Describe the study that explored the hypothesis that control of periodontal infection improves metabolic control of diabetes
  5. Elaborate on the link between severe periodontal disease in pregnant women and increased risk of delivering pre-term low birth weight babies, and discuss the possible reason for this relationship.

  6. Describe the role of saliva in fighting plaque and gum disease.

  7. Identify signs and symptoms of diabetic emergencies–hypoglycemia and hyperglycemia–and suggest emergency measures during a dental appointment.

  8. Establish the connection between diabetes and periodontal disease. 

  9. Explain the pathophysiology of dental infections in diabetic patients and list factors contributing to periodontal disease.

  10. Explain the importance of maintaining natural dentition in diabetic patients.

  11. Explain to the patient the link between diabetes and periodontal disease.

  12. Explain the link between diabetes and periodontal disease , and discuss the impact of factors such as diabetic control, blood vessel changes, bacteria and smoking on the disease.

  13. Emphasize the importance of good diabetic control on controlling the periodontal disease, and vice versa.

  14. Describe to the patient the progression of periodontal disease from gingivitis to periodontitis.

  15. Describe the treatment of periodontal disease, including plaque removal and periodontal surgery.

  16. Provide 4 important tips to a diabetic patient regarding dental health and oral surgery.

  17. Discuss other oral problems linked to diabetes, such as dental cavities, thrush, dry mouth.

To assess the effectiveness of the course material, we ask that you evaluate your achievement of each learning objective on a scale of A to D (A=excellent, B=good, C=fair, D=unsatisfactory). Please indicate your responses next to each learning objective and return it to us with your completed exam.