Dental Restorations and Diabetes: What It Means for Case Planning

Diabetes, especially when poorly controlled, raises the risk and severity of periodontitis and can slow healing, so plaque control around margins matters more. A lab can support the dentist with smooth, well-polished surfaces, cleansable contours and accessible margins. Clinical decisions stay with the treating dentist.

November is American Diabetes Month. This is a lab-side look at what diabetes can mean for restorative case planning. Clinical decisions are always the treating dentist's.

Diabetes changes the mouth a restoration has to live in. For a lab, that doesn't change how carefully a case is made, but it can change what we'd recommend: material, margin placement, contours and how easy the result is to keep clean.

Diabetes and periodontal disease: the two-way link

The relationship between diabetes and periodontitis runs both ways. Diabetes, especially when poorly controlled, raises the risk and severity of periodontitis, and periodontal inflammation can make glycemic control harder. This two-way link is the conclusion of the joint consensus report of the European Federation of Periodontology and the International Diabetes Federation (Sanz et al., Journal of Clinical Periodontology, 2018).

For a restoration, that means the tissue around it may be less stable over time, and plaque control around margins matters even more.

Healing and timing for restorations

Patients with poorly controlled diabetes can heal more slowly. That can affect when tissue around a prep or an extraction site is stable enough for final impressions, and it's one reason some dentists build more time into these cases. If a case needs to be timed around healing, tell us when you schedule it, and we'll plan the date with you rather than against you.

Design choices that support hygiene

Where the clinical situation allows, a few design choices make a restoration easier for the patient to keep clean:

• Smooth, well-polished surfaces. Highly polished or glazed surfaces accumulate less plaque. Every AIM restoration is finished and examined under high-powered microscopy before it ships (see The 20-Micron Margin).
• Cleansable contours. Overcontoured crowns trap plaque. Natural emergence profiles and open embrasures where appropriate make hygiene easier.
• Accessible margins. Where esthetics allow, margins that the patient can reach are easier to maintain.

Dental implants for patients with diabetes

Poorly controlled diabetes is associated with a higher risk of peri-implant disease, so long-term maintenance matters. Some dentists prefer screw-retained restorations for these patients because they can be removed for cleaning and assessment without cutting. We make screw-retained crowns on Ti-base, as well as CAD/CAM-milled custom titanium abutments with an emergence profile designed for the individual patient. More on our implant services.

Dentures and partials for patients with diabetes

Diabetes is associated with dry mouth and a higher risk of oral candidiasis, which can make denture wearers more prone to sore spots and denture stomatitis. A well-fitting, highly polished denture base helps. See our removable dentures and partials. If a patient's tissue is fragile, tell us on the Rx so we can plan for it.

What to tell us on the Rx

You don't need to send a medical history. A short clinical note on the Rx is enough for us to plan the case well, for example:

• Tissue that's inflamed, receding or still healing
• A preference for screw-retained over cement-retained on an implant case
• Any concern about cleansability or margin access
• Timing constraints because of healing

A quick note helps us plan the case right the first time; see The Communication Habit That Prevents Most Remakes and the case submission checklist. Questions about a specific case? Call us at (718) 854-3900 or schedule a pickup.