Should diabetics put off having a cleaning due to the Pandemic?

My father was a diabetic who was not always well controlled. He enjoyed food too much and smoked off an on until his death at 81 years of age. His home care wasn't that good and he wore a maxillary full denture since he was in his late sixties. This is not terribly unusual for diabetic patients but it may be avoidable with proper home care and regular dental visits ( in my practice we recommend 3 month recall for our diabletic patients.

According to the American Diabetes Association, more than 10% of the U.S. population has diabetes.  Further more the American Academy of Periodontology website explains that:

People with diabetes are more likely to have periodontal disease than people without diabetes, probably because people with diabetes are more susceptible to contracting infections. In fact, periodontal disease is often considered a complication of diabetes. Those people who don't have their diabetes under control are especially at risk.

Research has suggested that the relationship between diabetes and periodontal disease goes both ways - periodontal disease may make it more difficult for people who have diabetes to control their blood sugar.

So the answer to whether  diabetics should delay their cleaning, is simple. If they can safely get to their dentist's office, they should not delay their cleanings. Since many people have put on weight in the last 6 months eating comfort food, it seems likely that some diabetic patients are no longer in good control and should not further delay their dental check up and cleaning.   If your dentist is taking appropriate steps ( ambient air management, wearing PPE, and screening staff and patients) the risk of contracting Covid 19 while at the dentist is quite minimal. Most dentists have restricted the number of patients allowed to be seen at any given time. Patients are instructed to not show up early for their appointments and if possible wait in their cars before being seen.  If a patient wears their mask until they are seated in the dental chair they should have a minimal risk. I joke with my patients that given all the precautions we are taking, our office is safer than most places they can go ( supermarket, take out restaurant, drug store)

On the other hand, the risk to the diabetic patient not having their cleaning is that their oral and overall health my definitely be adversely affected. This is especially true for diabetics who are not under good control. Diabetics are more prone to dental infections and bone loss due to periodontal disease and are more prone to tooth loss than the average population. In our office, we recommend a three month recall schedule for most of our diabetic patients. 

Our office was closed for three months this spring and during this time we were advised to only treat patients with true emergencies. Preventive dentistry such as check ups and cleanings were off the table. When we started seeing patients again, it was obvious that many of those who had been unable to get their regular cleaning had problems made worse by their delay, Many had inflamed gums or cavities that were made worse because they were unable to see a dentist.

Now may be an especially good time to see a dentist in NYC since the city is not crowded and our rate of new infections is down to1%. Yes, even though they may be at higher risk for Covid complications, our patients should mask up and go in for a  scheduled cleaning. The risk is very low and the benefits are high!

from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2020/08/should-diabetics-put-off-having.html - http://lspindelnycdds.blogspot.com/