Dr. Soheel Hussain Zargar
Dentist
Diabetic patients needs to be taken special care.
First of all you need to have fresh tests for Fasting blood glucose which should be around 100 t 125mg/dl and post prandial to be around 140mg/dl.These are safest ranges in which you can try extraction at dental clinic.
However if we report a diabetic patient it is always better to do an extraction if he is hyperglycemic than hypoglycemic where hypoglycemic shock can precipitate.
Now when should we do extraction :Preferably asking patient to get with him glucometre and do tests before extraction is planned.
Next is in always tell the patient to come for extraction after eating something .As i already mentioned hypoglycemia is always a dangerous thing than hyperglycemia.so if a patient is hyperglycemic then no problem.you can do if you are confident and have enough human and technical support at clinic.
Another thing is there is chance of bleeding which cant stop as in diabetes wounds also doesnt heal easily.so always get patients CBC,CTBT tests done.
Try atraumatic extraction as much as possible without much instrumentation.you can try elevator with patience and it can do the job.
Fourth always try to suture the extraction site even if there is less need as dry socket chances are highest in diabetic patients.
Rest after extraction keep patient for wsit and watch for 30 minutes to avoid any hypotensive episode to happen.
At last it is better to manage complicated patients if you have technical and manpower support available.
04.Oct, 06:33pm