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Understanding Diabetes in Dental Care

Diabetes and oral health are closely linked, yet this connection is often overlooked. Diabetes mellitus is a group of metabolic conditions that cause persistently high blood glucose levels, either because the body produces too little insulin or cannot use it effectively. As diabetes is common, dentists frequently encounter patients living with this condition and must consider how blood sugar control affects oral health and dental care.

Good dental care plays an important role in overall diabetes management. Dentists must understand how diabetes affects oral health and how treatment plans may need adjustment.

Dental Considerations for People with Diabetes

These findings highlight why diabetes, and oral health must be managed together. Diabetes can affect people of any age. As with all patients, dentists should review medical history, record vital signs, and look for oral signs that suggest poor blood sugar control.

Common oral manifestations of uncontrolled diabetes include:

  • Dry mouth (xerostomia)

  • Burning sensations in the mouth

  • Delayed or impaired wound healing

  • Increased risk and severity of infections

  • Oral fungal infections such as candidiasis

  • Enlargement of the parotid salivary glands

  • Gingivitis and periodontitis

Recognising these signs early allows dentists to adjust care and refer patients when needed.

Cortisol word

Key Questions Dentists May Ask

To assess diabetes control and dental risk, a dentist may ask:

  • At what age were you diagnosed, and what type of diabetes do you have?

  • What medications are you currently taking?

  • How do you monitor your blood sugar levels?

  • How often do you see your doctor, and when was your last visit?

  • What was your most recent HbA1c (A1C) result?

  • Do you experience episodes of very low or very high blood sugar?

  • Have you noticed disorientation, agitation, or anxiety without a clear cause?

  • Do you have mouth sores, discomfort, or dryness?

  • Do you have diabetes-related conditions such as heart disease, stroke, eye problems, numbness, kidney issues, or a history of gum disease?

These questions help dentists plan safer and more effective treatment.

Diabetes and oral health

Appointment Timing and Cortisol Levels

Morning appointments often work best for patients with diabetes. Cortisol levels tend to be higher earlier in the day, which raises blood sugar slightly and lowers the risk of hypoglycaemia.

For patients using short- or long-acting insulin, dentists should avoid scheduling appointments during peak insulin activity. Dentists should also confirm that patients have eaten normally and taken their prescribed medications before treatment.

If a planned procedure requires fasting or altered eating patterns, such as conscious sedation, the dentist should coordinate with the patient’s physician to adjust diabetes medication safely.

Managing Dental Procedures Safely

Careful planning helps reduce complications related to oral health complications of diabetes. Patients with well-controlled diabetes usually tolerate most dental and surgical procedures without special modification. However, when treatment affects eating after surgery, dentists should establish a clear plan to balance food intake and medication use in advance.

For patients with marginal or poorly controlled diabetes, dentists may need to postpone elective procedures until blood sugar levels stabilise. In such cases, coordination with the patient’s physician helps ensure safe and effective care.

Medical–Dental Collaboration Matters

Physicians should provide relevant laboratory results when requested and inform dentists of any diabetes-related complications before dental procedures. In some cases, doctors may adjust diabetes medications to support stable blood sugar levels before, during, and after surgery.

People living with diabetes benefit most from regular medical follow-ups and consistent dental care. Routine dental visits allow early detection of oral complications and support long-term oral and overall health. PRIME

Author

  • Dental Surgeon, Founder of B9 Dental Singapore 

    Dr Raymond Lim graduated from the National University of Singapore with a Bachelor of Dental Surgery (B.D.S.). In 2013, he founded the B9 Dental Centre, which has placed emphasis on acquiring latest medical technology, maintaining strict hygiene standards and providing quality services to the patients since the beginning.

    For the past four years, B9 Dental Centre has always been providing quality services at a price which is fair, reasonable and transparent. It has garnered recognition from the patients and in the industry through various awards, motivating Dr Lim and his team to work even harder. The team hopes to change the way people see and understand dental care, and to offer better service to the patients.

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