Diabetes Mellitus (DM) and Extraction: Case 1

A 62 year old female patient came to department of Oral and Maxillofacial Surgery with chief complaint of decayed teeth in upper right back and lower left back region of jaw since 2 years. She had a medical history of Diabetes Mellitus and was under medication for it since two years.

On examination:
Root stump w.r.t. 18, 15, 14, 38

For this, we send her for medical consultation and told her to come with medical report for
1. Fasting Glucose Level,
2. Postprandial  Glucose level and
3. HbA1c

Her Fasting glucose level was 107 and Postprandial glucose level was 198.

As we know, extractions can be performed with
Fasting glucose level < 125
Postprandial glucose level < 200.
If we go for extraction above this level, there is high chance of post operative complications, especially post operative infection and delayed wound healing. So, we called the patient after one day with antibiotic prophylaxis of 1 g Amoxicillin one hour before extraction as it was of borderline case.

 Note: 
Extraction is contraindicated in case of uncontrolled diabetes Mellitus or poorly controlled Diabetes Mellitus i.e. Fasting glucose level > 125 and Postprandial glucose level > 200.

Extraction was successfully done and proper post operative instructions given with prescription:
1. Cap. Amoxicillin 500 mg p/o x tds x 5 days
2. Tab. Metronidazole 400 mg p/o x tds x 5days
3. Tab. Ibuprofen 400 mg p/o x tds x 1 day then sos
4. Tab. Pantoprazole 40 mg p/o x od x 5 days.