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JADA Continuing Education

Considerations for Dentistry

Background. The connection between oral health and systemic health is bidirectional; systemic illnesses, especially metabolic disorders, affect oral health, and it appears that oral health may affect systemic health.

Methods. In this review, the authors outline the basic principles behind diabetes mellitus (DM) and provide some tips to help dentists manage the care of patients with DM better in general practice.

Results. DM negatively affects all microvasculature beds, and the soft tissues and bones supporting the teeth are susceptible. There is also strong evidence that the presence of periodontal disease is associated with increased cardiovascular morbidity in patients with DM.

Conclusions. DM is a chronic, systemic metabolic disorder in which the orosystemic connection is becoming more understood.

Clinical Implications. DM is a relatively common condition and, thus, is one that practicing dentists may encounter frequently.

Key Words: Diabetes; insulin; hypoglycemia; periodontal disease

Abbreviations: DM: Diabetes mellitus. • GDM: Gestational diabetes mellitus. • HbA_1c: Glycosylated hemoglobin. • MI: Myocardial infarction. • MODY: Maturity-onset diabetes of the young. • NPH: Neutral protamine Hagedorn. • OHA: Oral hypoglycemic agent.