Endocrinology Flashcards
Disorders of which endocrine organs are important for dentistry?
Pancreas
Adrenal glands
Thyroid gland
What should be considered when in a dental clinic regarding posterior pituitary hypofunction?
LA is the most satisfactory means of pain control
Conscious sedation may be needed to control anxiety
Dentistry is usually uncomplicated by this disorder except dryness of the mouth
What percentage of diabetes is insulin dependent?
90 - 95%
What are the potential complications of diabetes (uncontrolled)?
Nephropathy
Neuropathy
Macrovascular disease
Altered wound healing
And possible increased incidence and severity of periodontal disease
How should care be coordinated with the GP?
The dentist should review the patients history take vital signs, and evaluate for oral signs and symptoms
If the patient has severe periodontal disease, the physician should be reminded that periodontal therapy may improve metabolic control and allow adjustments in drug dosages.
What are the diagnostic tests for glucose?
Fasting plasma glucose
Random plasma glucose
2-hour plasma glucose
HbA1c
What do HbA1c levels tell us?
Normal range <6%
Good control <7%
What is the primary goal of diabetes management?
To reduce microvascuar and neuropathic complications
and maintain HbA1c <7%
How can type 2 DM be treated?
Type 2 DM can be treated with weight loss, exercise and oral antidiabetic medication
What are the potential outcomes for patients with diabetes?
Blindness
Kidney failure
Heart disease
Stroke
Limb amputation
Peripheral neuropathy
What should dentists ensure they look at regarding patients with diabetes?
Evaluation and medical history.
Diabetics require a complete medical history
How should dental management occur in diabetic patietns?
Marginally or poorly controlled diabetics should be treated with caution
Elective dental treatment should be avoided until the patient is stabilized
If the patient has associated medical complications apply appropriate steps necessary in management
Patients should be encouraged to maintain excellent oral hygiene and comply with recall appointments
If dental caries is a potential problem, fluoride containing caries preventative agents are appropriate
Xerostomia should be managed on a case by case basis
Why should dental management of diabetic patients be so different?
To minimize risk of infection post oral surgery
How does dental surgery affect patients?
Surgical stress promotes hyperglycaemia through release of various hormones and inflammatory cytokines
Possibly predisposing patients to ketoacidosis
Should implants be sed on diabetic patients?
Dental implants can be successful in well-controlled diabetes but in poorly controlled diabetes it should be avoided and has unpredictable prognosis.
