Medical Emergencies · patient case question
Which oral finding is associated with diabetes mellitus?
Patient case: Emergencies and risk assessment
demo: Assorted patients
chief: Several patients present with findings that alter the safety of planned dental care.
history: One patient with well-controlled asthma using albuterol reports her last attack was ten months ago. Another feels faint on being returned to upright. A third has type 1 diabetes and presents unwell with deep rapid breathing and a fruity breath odour.
meds: Albuterol; insulin; various.
findings: Not applicable.
Show answer and explanation
Correct answer: B. Bilateral parotid enlargement and reduced salivary flow
- A. The direction is reversed. Salivary flow falls and the glands enlarge rather than atrophy.
- B. Correct. Diabetic sialadenosis produces painless bilateral parotid enlargement, and hyposalivation is common through osmotic diuresis, dehydration and autonomic neuropathy. The consequences follow: increased caries, candidiasis, burning mouth and accelerated periodontal breakdown.
- C. Enamel hypoplasia reflects a disturbance during crown formation and is not a feature of diabetes acquired in adulthood.
- D. Condylar resorption is associated with connective tissue disease and idiopathic condylysis, not with diabetes.
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