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Do preoperative glycosylated hemoglobin (HbA1C) and random blood glucose levels predict wound healing complications following exodontia in type 2 diabetes mellitus patients?—a prospective observational study

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Abstract

Background

Many dental surgeons consider a type 2 diabetic patient to be at higher risk for wound healing complications following exodontia. Random blood glucose (RBG) and glycosylated hemoglobin (HbA1C) values help the surgeon determine the glycemic control and assess if the patient can undergo the surgical procedure.

Objectives

The purpose of this study was to analyze if preoperative HbA1C and RBG testing could predict the risk of wound healing and infectious complications in type 2 DM patients undergoing exodontia in an office setting.

Methods

This prospective observational study included 133 type 2 diabetic patients and age- and gender-matched non-diabetic patients undergoing exodontia. Preoperative HbA1C values and random blood glucose levels were obtained for patients in both groups. Wound healing and infectious complications and additional interventions performed were recorded.

Results

Duration of diabetes ranged from 1 to 25 years. 80.5% of diabetics were treated with oral hypoglycemics. A vast majority of patients in both groups underwent extraction of only a single tooth. There was no significant difference in non-infectious complications between the two groups. The absolute risk of infectious complications in diabetics was 10.5% compared to a 6.8% risk among the control group. Age, RBG values, HbA1C, duration of DM, and number and nature of exodontia performed did not show any statistical significance.

Conclusion

This study observed a slight, but not statistically significant increase in the risk of infectious complications in type 2 DM patients undergoing exodontia. Surgical site infections were amenable to surgical drainage with or without oral antibiotics on an outpatient basis with favorable healing outcomes.

Clinical relevance

The RBG and HbA1C values were not significantly associated with risk of infectious complications. Resorting to prophylactic antibiotics and warning about possible adverse healing for routine exodontia in type 2 DM patients is unnecessary.

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Acknowledgments

We would like to thank Drs. Akilesh Ramasamy and Nirmal Pratap Mote for their contributions to patient care in this study.

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Authors and Affiliations

  1. Department of Dentistry, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), 74, 4th Cross, Thanthai Periyar Nagar, Pondicherry, 605005, India

    B. Krishnan, G. Arun Prasad, R. Saravanan & B. Madhan

  2. Dept of Internal Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Pondicherry, 605005, India

    T. Kadhiravan

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  1. B. Krishnan
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  2. G. Arun Prasad
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  3. R. Saravanan
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  4. B. Madhan
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Correspondence to B. Krishnan.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Krishnan, B., Prasad, G.A., Saravanan, R. et al. Do preoperative glycosylated hemoglobin (HbA1C) and random blood glucose levels predict wound healing complications following exodontia in type 2 diabetes mellitus patients?—a prospective observational study. Clin Oral Invest 25, 179–185 (2021). https://doi.org/10.1007/s00784-020-03349-7

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