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What could be the reason of denial for extracting tooth of a diabetic patient ?

My dad is 80 years old and is a diabetic. He wants one of his tooth to be extracted. He went to a dentist and he said he doesn t operate on diabetic patients. But my dad is not on constant insulin . He just takes two (5mg) pills of Glibenclamide daily in the morning. What could be the real reason behind his refusal? Would appreciate answer asap!
Asked On : Sat, 31 Mar 2012
Answers:  10 Views:  106
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  User's Response
A dentist cannot refuse to perform any oral surgical procedure if the blood-sugar levels of a diabetic patient are under control levels. If the patient gives history of non healing previous extractions or any other wound than the dentist can ask for latest blood-sugar reports and may even ask the patient's diabetologist weather its safe to do extractions. In uncontrolled diabetes, the extraction wounds don't heal and get infected. At 80, the body becomes physically compromised. Take latest blood-sugar reports of your father along with you when you visit your dentist. Even if the diabetes is uncontrolled, a patient suffering from pain cannot be denied treatment. There are various forms of bleeding controlling drugs available which are often applied on the extraction wounds to stop bleeding and promote healing. Find a good dentist.
Answered: Tue, 10 Apr 2012
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Dentist Dr. Deepthi Reddy's  Response
Hi
Thank you for the query.
Extraction at a age of 80 yrs for a diabetic patient is not adviced but under few circumstances it can be done if the patient is controlled diabetic and the teeth is mobile . Reason for the refusal is for a diabetic patient that to aged 80 yrs its difficult for the wound to heal and can end up with post extraction complications like unhealed wound leading to sepsis . So keeping the medical condition of the patient in mind and age of the patient your dentist refused to extract . Yes , this can be done with the concern of your diabetician if he says the patient is fit to under go the procedure.
Take care.
Answered: Sat, 19 Jan 2013
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General & Family Physician Dr. Divya Kuttikrishnan's  Response
Hi there,

Diabetes as such is not a contraindication for tooth extraction provided the sugars are well under control. Hence tooth extraction can be done after a medical consultation if the Fasting and Post prandial blood sugars are well under control. If sugars are not controlled, it could lead to prolonged bleeding and delayed healing of the socket wound.

Elderly diabetes patients are more prone to develop hypoglycemia.Also the symptoms of hypoglycemia may be masked in the elderly. Probably all these factors are the reason for doctor's refusal.

Hope I've answered your question.

Have a nice day :)
Answered: Sat, 31 Mar 2012
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Dentist, Periodontics Dr. Arati C Koregol's  Response
Hello
Thanks for the concern
In case of diabetes patients if the blood sugar levels are high extraction could be done because they are more prone to infections and delayed would healing process. this is the reason why the dentist have refused for extraction. its not the matter of amount of insulin consumption,its matter of whether sugar level is under control inspite of being on treatment for diabetes.
Hence get your fathers blood sugar levels assesed for both fasting and post prandial levels . if the values are under contro ldefinitly he can go for extaction with consent from his physician.
Take care
Hope i have tried to clarify your doubts.
Answered: Sat, 31 Mar 2012
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General & Family Physician Dr. Kimberly Martin's  Response
Hello hkeducation.first. Thanks for visiting healthcaremagic.com. Your father is 80 years old and diabetic, which increases his risks of complications during/after surgery including dental surgery. I assume that this is the reason that the dentist does not want to operate. Your father can be referred to a dentist that will operate on his tooth.

IF your father is going to undergo general anesthesia or if it going to be a long procedure, the dentist may want to have your father have a cardiac workup, if this has not been done recently, to lower your father's risk of complications after surgery.

Be well, Dr. Kimberly
Answered: Sat, 31 Mar 2012
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Internal Medicine Specialist Dr. Rudramani Swami's  Response
HELLO
THANKS FOR POSTING YOUR QUERY AND YOUR CONCERN
KINDLY CHECK YOUR FATHERS FASTING AND POSTMEAL SUGAR LEVEL.IF THESE LEVELS ARE WITHIN NORMAL LIMITS,THERE IS NO HARM IN EXTRACTING TOOTH .PREFERABLY GET EXTRACTION DONE IN MORNING HOURS, IF SUGAR LEVELS ARE NORMAL SO THAT YOU CAN OBSERVE WHOLE DAY FOR EXCESSIVE BLEEDING.IF SUGAR LEVEL IS MORE HE NEEDS ADJUSTMENT IN THE DOSASGE OF HYPOGLYCEMIC AGENTS.CONSULT PHYSICIAN OR DIABETOLOGIST FOR DOSE ADJUSTMENT.DONT STOP MEDICATION BEFORE MEAL ON DAY OF EXTRACTION.
I HOPE,I HAVE ANSWERED YOUR QUERY.I WILL BE AVAILABLE FOR FURTHER QUERIES.
REGARDS

Answered: Sat, 31 Mar 2012
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Dentist Dr. Deepika Attresh's  Response
Hello & welcome
usually extractions & other surgical procedures are not done on uncontrolled diabetic patient, but if diabetes is in control and your father is taking regular dose than there is no such contraindication.
Diabetic patients show some delayed wound healing after extraction so have to maintain proper oral hygiene. rest no problem.
thanks & take care
Answered: Sat, 19 Jan 2013
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Dentist Dr. Inderpreet Singh's  Response
sir the denial is not a permanent one . its related to your dad's control of his sugar levels. the treatment of diabetes whether insulin or just tablets doesn't matter because that changes patient to patient. the goal of a physician for a diabetic patient is to normalise his sugar levels.
increased sugar levels are said to be associated with delayed would healing post extraction along with other general factors which reduce the general health.
Answered: Tue, 23 Oct 2012
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Dentist Dr. Bindiya Bhaskar's  Response
hello,

in diabetic patients,there is more chance of uncontrolled bleeding after tooth extraction.
also your dad is at the age of 80,so there is more chance of delay in wound healing.
consult with your physician and any other dentist.

if necssary,blood clotting drugs can be taken prior to tooth extraction.

regards
dr.bindiya
Answered: Sun, 20 Jan 2013
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Dentist, Endodontics Dr. Shweta Sehgal's  Response
hi
tooth extraction is a relative contraindication in case of diabetic patients. An extraction can be done in case of controlled diabetes but proper lab reports and physician consent is required...As in this case your father is 80yrs old and is diabetic so extreme care needs to be taken during extraction , as bone strength is compromised at this stage and patient cannot take stress involved during the procedure...but still it can be performed after the lab reports and treating physician's consent...

I hope i have answered your query well...
best of luck...
Dr. Shweta Sehgal
drshwetasehgal@yahoo.com
Answered: Tue, 10 Apr 2012
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