Geriatric Patient Summary

Diabetes mellitus is a chronic metabolic condition defined by hyperglycemia caused by insulin insufficiency, resistance to insulin action, or both. Because chronic hyperglycemia can cause difficulties in several parts of the body, including the mouth, blood glucose control is crucial. Impaired neutrophil function, increased collagenase activity, a reduction in collagen production, microangiopathy, and neuropathy are all possible causes linked to diabetic oral problems. Oral manifestation related to diabetes mellitus include dry mouth (xerostomia), burning sensations, tooth decay (including root caries), periapical lesions, defective wound healing, higher risk of infection and oral candidiasis. Salivary dysfunction is common in diabetic patients, and it can result in decreased salivary flow and a change in saliva composition. The prevalence of xerostomia in diabetic patients is reported to be between 34 and 51 percent
(Rohani, 2019).

For the patient I treated, the clinical modifications that are recommended are stress reduction, short morning appointments to keep blood glucose levels from rising, as well as regular questionnaires to make sure that the patient has eaten and took medications prior to the appointment. It is important to create a warm, quiet and comfortable atmosphere in order to lessen patient fatigue and emotional stress. Diabetic patients are more likely to acquire new or recurring dental caries. Increased levels of oral yeasts, mutans streptococci, and lactobacilli, as well as decreased saliva cleansing and buffering capacity, can all contribute to an increase in the prevalence of tooth decay. Chronic hyperglycemia can also lead to permanent pulpitis and pulp necrosis. For this patient, proper oral care is really important since they are at higher caries risk. The patient should avoid sugary or acidic foods and drinks because they increase the risk of caries as well (Rohani, 2019).

The oral hygiene care recommendation for this patient is prophylaxis every three months due to the higher risk of developing periodontal diseases. Also, a fluoride varnish application is recommended for this patient for extra protection against tooth decay. Fluoride varnish reduces the progression of deterioration by preventing demineralization. It strengthens enamel against acid assault and accelerates remineralization (Urbach Pediatric Dentistry, 2021).

The home care recommendations for this patient are to brush teeth at least twice a day, in the morning, and after meals and snacks, if possible. Use a fluoride-containing toothpaste at least twice a day in combination with a soft-bristled toothbrush. The patient should avoid scrubbing the teeth too hard because it can irritate gums and replace the toothbrush every three months. The patient should also use mouthwash designed for dry mouth at least two times a day to help increased saliva flow and help with dry mouth discomfort (Salinas, 2017).

References:

Rohani B. (2019). Oral manifestations in patients with diabetes mellitus. World journal of
diabetes, 10(9), 485–489. https://doi.org/10.4239/wjd.v10.i9.485
Salinas, T. J. (2017). Dry mouth treatment: Tips for controlling dry mouth. Retrieved November 13, 2021, from https://www.mayoclinic.org/diseases-conditions/dry- mouth/expert-answers/dry-mouth/faq-20058424
Urbach Pediatric Dentistry. (2021). Benefits of fluoride varnish treatment. Retrieved November 13, 2021, from https://urbachpediatricdentistry.com/benefits-of- fluoride-varnish-reatment/

The post Geriatric Patient Summary Diabetes mellitus is a chronic metabolic condition defined by appeared first on PapersSpot.