Questions and Answers
What is the nature of the orthodontic patient base?
It continues to evolve, requiring understanding of medical disorders
What is the basic management of diabetes in orthodontic patients?
Understanding the fundamental disease and therapy for medical problems
What characterizes Type I diabetes?
Insulin dependent, sometimes termed as Juvenile onset
What is the contra-insulin effect in diabetes of pregnancy caused by?
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What is the essential reason for appliance removal in orthodontic treatment for patients undergoing chemotherapy?
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Why is orthodontic treatment generally not advisable for patients undergoing treatment for hematologic malignancies?
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Why do patients with severe hemophilia require special consideration during orthodontic treatment?
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What is a potential risk associated with factor concentrates derived from human blood donations?
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Why do children with Juvenile Rheumatoid Arthritis (JRA) require additional support for oral hygiene during orthodontic treatment?
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What is a common concern when considering orthodontic treatment for children with cystic fibrosis?
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Which type of leukemia is the most common childhood malignancy?
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What should be the controlled diastolic pressure for hypertensive patients on medication?
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In acute hypertensive crisis, what medication should be administered or the patient should be referred to a physician?
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What percentage of childhood malignancies do leukemias account for?
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Which type of lymphoma consists of Hodgkins and nonHodgkins types?
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How are leukemias classified?
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What may arise in different lymphoid tissues and have various subgroups?
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What should the dental team consider in leukemia patients undergoing chemotherapy?
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What should be avoided in gingival packing material for hypertensive patients?
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Which type of leukemia is characterized by different characteristics and prognosis in children?
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What is the most common childhood malignancy?
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What is the percentage of childhood malignancies accounted for by lymphomas?
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What is the primary effect of cystic fibrosis?
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Which individuals are equally affected by cystic fibrosis?
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What are the main clinical manifestations of cystic fibrosis?
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In some cases of respiratory failure, what has been successful for cystic fibrosis patients?
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What is the current median survival for individuals with cystic fibrosis?
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When should orthodontic treatment for cystic fibrosis patients be considered?
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What should be avoided in orthodontic treatment for cystic fibrosis patients?
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Which glands are often affected by cystic fibrosis, leading to reduced salivary volume during orthodontic treatment?
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What is relatively uncommon but can result in substantial morbidity and mortality for cystic fibrosis patients?
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What is recommended for certain high-risk endocarditis individuals before dental procedures?
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What are some oral manifestations of diabetes?
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What can orthodontic procedures, particularly banding and debanding, lead to in cystic fibrosis patients?
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What is a complication of diabetes in pregnancy?
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What must orthodontists consider when making treatment decisions for cystic fibrosis patients?
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What is recommended for orthodontic treatment in diabetic patients?
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What may result from renal or non-renal causes in hypertension?
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What should be considered during dental treatment for patients with hypertension?
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What are some vascular and non-vascular complications experienced by diabetic patients?
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What is required for pregnant patients with diabetes during the second and third trimester?
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What can antihypertensive medications potentially cause in patients with hypertension?
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What should be done if diabetic comas occur during dental treatment?
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What can prevent many complications of diabetes?
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What may be experienced by patients with hypertension due to antihypertensive medications?
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What are some oral manifestations of diabetes that may be emphasized, especially with fixed appliances?
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Study Notes
Diabetes and Hypertension in Dental and Orthodontic Treatment
- Pregnant patients with diabetes require insulin therapy during the second and third trimester, which should be discontinued after placenta removal.
- Complications of diabetes include hyperglycemia, ketoacidosis, hypoglycemia, and up to 9% fetal death in pregnancy-related diabetes.
- Good diabetic control and achieving normoglycemic state can prevent many complications of the disease.
- Oral manifestations of diabetes include xerostomia, oral candidiasis, impaired wound healing, and periodontal disease.
- Orthodontic treatment in diabetic patients requires good medical control, stress-free procedures, and emphasis on oral hygiene.
- Diabetic comas during dental treatment require immediate treatment, including placing the patient in a supine position and administering diagnostic glucose.
- Hypertension may result from renal or non-renal causes, and essential hypertension accounts for two-thirds of cases.
- Patients with hypertension may be treated with antihypertensive medications that can cause xerostomia.
- Dental/orthodontic treatment in patients with hypertension requires checking blood pressure, determining the degree of control, and considering postural hypotension.
- Care should be taken when patients with hypertension rise from the dental chair, especially after long procedures or when using nitrous oxide.
- Diabetic patients may experience vascular and non-vascular complications, including microangiopathy and neuropathy.
- Dental procedures for diabetic patients should be stress-free, and oral hygiene should be emphasized, especially with fixed appliances, which can increase plaque retention.
