The diabetic dental patient.

DM is such a common disease in the United States that virtually every dentist encounters patients with known or undiagnosed diabetes. The dentist should be alert for both general and oral signs and symptoms suggestive of uncontrolled or poorly controlled DM, and laboratory or interoffice screening tests should be a part of dental practice. Under no circumstances, however, should the dentist attempt to diagnose the disease. Patients with suggestive symptoms or with abnormal blood glucose levels identified by screening tests should be referred to a physician for diagnosis and any treatment necessary. Uncontrolled DM may be associated with increased frequency and severity of oral infections, including periodontal disease and dental caries. In some diabetic patients, susceptibility to oral disease may continue despite establishment of effective metabolic control. Dental treatment can safely be performed on the controlled diabetic patient, but some adjustment of office protocol and of antihyperglycemic drug administration may occasionally be necessary. Finally, the dental treatment team must always be alert for signs and symptoms of developing diabetic emergencies and be prepared to provide treatment as necessary.