Assessment of post operative wound healing in diabetic patients after extraction

Diabetes is a common metabolic disorder characterised by an inability to regulate blood glucose due to insulin deficiency or resistance. Type 1 diabetes or insulin dependent diabetes is characterised by deficient insulin production whereas type II or non-insulin dependent diabetes results from relative insulin deficiency and tissue insulin resistance. Traditionally in dentistry, diabetics are considered to have increased healing problems related to dental extractions, periodontal surgery and wearing ill-fitting dentures. They are also considered more likely to have infections. Although this may be so for poorly controlled Type 1 diabetics, there is only unreliable support for this view for Type 2 diabetics on oral hypoglycemics. In dentoalveolar surgery, diabetic patients could be expected to suffer various complications to those observed in other surgical procedures such as the most commonly seen is delayed wound healing. However, the oral environment with the forces of mastication, high bone turnover, high vascularity, saliva and the constant reservoir of microorganisms is active from other parts of the body, thereby making generalisations from other surgical sites limited. Difficulties with extractions are unpredictable. Having a thorough medical history prior to surgery will allow the surgeon to better deal with complications that may arise. Be certain to always follow proper surgical techniques, and know your limitations prior to beginning any extractions. If and when difficulties develop, it is always recommended to explain the situation to the patient.