Uncontrolled Diabetic – Referred by Physician

  Background: The patient is a 41-year-old female who has not been seen by a dental professional since 2008 (10 years). The patient stated her chief concern as “My doctor said my uncontrolled diabetes could be caused by my mouth.” Other medical concerns are high blood pressure and acid reflux. The home care routine consisted of manual tooth brushing only. Following the periodontal assessment, the patient was diagnosed with active, localized, chronic periodontitis due to the present s...
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How do you speak Metabolic Health/Diabetes and Periodontal Disease to Your Patients?

Dr. McGlennen: Many resources confirm a bi-directional relationship between periodontal disease and Type II diabetes; which in simple terms means if you have one, you will most likely have the other. Elevated levels of periodontal bacteria can directly cause hyperglycemia.1 Long term, the inflammation associated with increased pathogen burden can affect the health of the pancreas. Specifically, there is the risk of the loss of beta cells that produce insulin and respond to elevated blood glu...
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Periodontal Patient with Poor Diabetic Control Combined with Poor Home Care

Challenge: A periodontal patient of record is diagnosed with active periodontal disease. Therapy is needed to achieve a healthier oral state; however the patient has uncontrolled diabetes combined with poor home care that may be contributing to the patient’s oral health status. Background:  A female patient of record, age 48, presented for periodontal maintenance on 11/19/2018. Upon periodontal assessment, the patient exhibited oral inflammation with bleeding, moderate calculus deposits a...
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Active Periodontal Disease with Multiple Medical Complications

Challenge: A patient with Multiple Sclerosis (MS) and active periodontal disease, most recently was diagnosed with Type II diabetes, will receive periodontal therapy. Currently, proper home care is limited to the physical difficulties of MS. Background:  A 58-year-old female presented on 4/17/2018 with a chief complaint of xerostomia and physical difficulties challenging a proper home care regimen. Due to living with MS for several years, the patient has partial left-side paralysis result...
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Type II Diabetic and Periodontal Disease

Challenge: A Type II Diabetic patient, who has been a long term client, has uncontrolled periodontal disease and a history of not responding to previous periodontal treatment. Background:  This 73 year-old female with Type II Diabetes has been a patient in our periodontal maintenance program for years. She has had several courses of active periodontal therapy never achieving complete periodontal remission. In the past year, our team has been upping our game by studying under Dental Hygien...
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An Uncontrolled Diabetic Patient – Referred by Physician

Background: The patient is a 41-year-old female who has not been seen by a dental professional since 2008 (10 years). The patient stated her chief concern as “My doctor said my uncontrolled diabetes could be caused by my mouth.” Other medical concerns are high blood pressure and acid reflux. The home care routine consisted of manual tooth brushing only. Following the periodontal assessment, the patient was diagnosed with active, localized, chronic periodontitis due to the present sub-gingiva...
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