Year: 2026
Type: article
Abstract: Background: Diabetes mellitus is a prevalent chronic metabolic disorder with important implications for oral health and dental care. Persistent hyperglycemia may affect immune function, inflammatory responses, vascular integrity, and tissue repair, potentially influencing the management and outcomes of dental treatment. Objective: This critical narrative review aimed to analyze the main clinical considerations and potential complications associated with dental treatment in patients with diabetes mellitus, with emphasis on pre-treatment assessment, periodontal therapy, invasive procedures, endodontic treatment, implant therapy, and the prevention of glycemic complications. Methods: A structured literature search was conducted in PubMed/MEDLINE and Scopus, complemented by focused searches in PubMed addressing hypoglycemia, periodontal therapy and glycemic control, antibiotic use, tooth extraction and wound healing, implant therapy, and endodontic outcomes. Recent clinical guidelines, systematic reviews, meta-analyses, and clinically relevant primary studies were prioritized. The literature was critically analyzed and synthesized according to its relevance to clinical decision-making, without quantitative meta-analysis. Results: Diabetes may influence periodontal inflammation, susceptibility to oral infections, tissue repair, and dental treatment outcomes. However, current evidence does not support the automatic exclusion of patients with diabetes from routine or invasive dental procedures solely on the basis of the diagnosis. HbA1c may contribute to risk stratification but should not be used as an isolated criterion for dental treatment eligibility. Particular attention should be given to hypoglycemia risk, especially in patients using insulin, sulfonylureas, or meglitinides. Periodontal therapy may provide a modest improvement in glycemic control, whereas tooth extraction, endodontic treatment, and implant therapy require individualized assessment according to metabolic status, systemic complications, local oral conditions, and procedural complexity. Conclusion: Diabetes mellitus should be considered an important modifying factor rather than an absolute contraindication to dental treatment. An individualized, evidence-informed approach integrating metabolic status, medication-related risks, oral conditions, and procedural characteristics is essential to minimize complications, support appropriate treatment planning, and avoid unnecessary delays in necessary dental care.
DOI: 10.66104/j7kg1358
Institution: Universidade Federal de Juiz de Fora
Language: English
Subfield: Periodontics
Field: Dentistry
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7212007262