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The Conversation – Medical History – Part 2 – Family History

December 6, 2021

The conversation continues with understanding the familia… well not the family tree and the skeletons in the closet, but certain conditions that run in families.

The most common examples that may affect treatment include diabetes and haemophilia.


It is insulin dependent diabetics in the family that we are concerned about. The patient in front of me may not have it but they may be a “closet diabetic”. What do I mean? Often a person with an underlying diabetic condition may not be aware they are diabetic. Sometimes the dentist may be the first to become suspicious of diabetes in the person.

Insulin is a hormone made in the pancreas to allow the cells to gain energy, i.e. glucose, from the surroundings tissues to get inside the cell. Without this, the cell does not run properly. This affects the immune system and the healing cells of the body.

Warning signs

  • Prolonged healing of gums after surgery
  • Persistent infections
  • Gum health deteriorating 
  • Poor gum response to healing after cleaning
  • Implants not adhering to bone and eventually failing

The patient needs further investigation and medical treatment.

Receding gums showing exposed roots and larger spaces between teeth. Also swelling in gum above front tooth.


This is a genetic condition affects part of the clotting cascade. This means the person continues to bleed for an abnormal time.

Warning signs

  • Some dental treatment, such as tooth removal, may result in continual bleeding.
  • Spontaneous bruising for no reason on other parts of the body.
  • Gum treatment or scale and clean causing an unusual amount of bleeding.

The patient needs urgent investigation and medical treatment.

This conversation may also save your life and warn your children and family.
Severe bleeding of the gums

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Next week

The Conversation - Part 3 - Dental History