MedEdPORTAL (Oct 2012)
Prevention, Detection, Evaluation, and Treatment of Dental Decay and Its Sequelae in Patients With Diabetes Mellitus
Abstract
Abstract While dental decay is not recognized as a complication of diabetes mellitus, individuals with diabetes are not immune to dental decay and its sequelae. Dental decay and its sequelae, although mostly chronic with mild symptoms, are infections that can become acute at any time and cause more serious maxillofacial space and deep neck space infections. Management of patients with diabetes is an essential part of the undergraduate and graduate curriculum of oral health professional education. However, it is important for all members of the diabetes patient care team to work together to optimize the outcome of oral health care in patients with diabetes mellitus. This resource provides an overview of dental decay and its sequelae, the current understanding of its aggressive progression and inadequate response to the treatment in diabetes mellitus patients, strategies of prevention, and early treatment. The resource not only offers fundamental knowledge of diabetes and dental decay but also provides mechanisms of interdisciplinary communications and team-based oral health care in diabetes mellitus patients. Studies have shown that diabetes patients, due to their impaired immunity, are more susceptible to Ludwig angina and extended deep neck space infections of odontogenic origin. These conditions require extensive antibiotic therapy, surgical drainage, intensive glycemic control, and longer hospitalization in patients with diabetes mellitus. Even with such extensive medical care, the conditions are likely to recur unless the infection source is removed. Prevention and early treatment of dental decay in patients with diabetes can avoid serious dental abscesses and life-threatening deep head and neck infection, septicemia, and death. They will also reduce health care expenditure and improve patients' quality of life. This resource is composed of a presentation, clinical case discussions, a clinical manual, and an instructor's guide. The presentation and case discussions are mainly to be used as a tutorial in the health care professional school curriculum (medical, dental, nursing, and others) of dental decay and its sequelae. They emphasize infection sources of head and neck abscess in diabetes patients and how oral health care professionals can spare patients from costly treatment and morbidity or mortality by removing these infection sources. Other health professional educators can also be benefit from the resource.
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