28/04/2026
How to MANAGE A kid with DIABETES as a pediatric dentist in your clinic
Before the appointment
* Take a good medical history: type of diabetes, medications (especially insulin), last HbA1c if known, history of hypoglycemia, hospitalizations, and physician follow-up.
* Ask if the child has eaten normally and taken their medication/insulin.
* Prefer morning appointments when glucose control is usually better.
* Keep appointments short and low-stress.
Watch for hypoglycemia (most urgent risk)
Common signs:
* Sweating
* Shaking
* Hunger
* Confusion
* Irritability
* Dizziness
* Tachycardia
* Weakness
If hypoglycemia happens
If conscious:
* Give fast sugar: juice, glucose tablets, sweet drink, sugar gel
15\text{ g glucose}
* Recheck after about 15 minutes if possible
If unconscious:
* Emergency protocol
* Glucagon if available
* Call emergency services immediately
Oral findings often seen
* Delayed healing
* Increased infection risk
* Gingivitis / periodontal problems
* Xerostomia
* Candidiasis
* Higher caries risk (depends on diet/control)
Dental treatment notes
* Routine care is fine if diabetes is reasonably controlled
* For poorly controlled diabetes or infection → consider medical consultation
* Treat acute infections promptly
* Good pain control and infection control are important
Local anesthesia
* Usually okay
* Use vasoconstrictor carefully if significant systemic concerns exist
Antibiotics
* Not routinely needed just because of diabetes
* Use only when there is a real infection/indication
Key difference
* Type 1: insulin-dependent, hypoglycemia risk is especially important
* Type 2: may be on oral meds and/or insulin, often associated with obesity and insulin resistance
The golden rule: Never treat a diabetic child who skipped breakfast and insulin instructions without checking first.
