Dental management considerations of a patient with congenital hyperinsulinism. Case report

• Autores: Butrón-Téllez Girón, Claudia, Hernández-Pérez, Daniela, Pierdant-Pérez, Mauricio
• Formato: artículo
• Fecha de Publicación: 2022
• Institución: Sociedad Peruana de Odontopediatría
• Repositorio: Odontología pediátrica
• Lenguaje: español
• OAI Identifier: oai:revistaodontologiapediatrica.com:article/208
• Enlace del recurso: http://www.op.spo.com.pe/index.php/odontologiapediatrica/article/view/208
• Nivel de acceso: acceso abierto
• Materia: Hiperinsulinismo congénito; Manejo dental; Ansiedad; Hipoglucemia; Caries dental; Congenital hyperinsulinism; Dental management; Anxiety; Hypoglycemia; Dental caries

Introduction: Congenital hyperinsulinism is characterized by dysregulation of insulin secretion, causing severe hypoglycemia in newborns, infants and children. Excessive stress and anxiety that occurs in the dental practice may induce excessive production of cortisol increasing blood glucose production of compensatory insulin which can lead to hypoglycemia during treatment, likewise, the use of some drugs and high consumption of carbohydrates of these patients to maintain adequate levels of glucose, may cause alterations in the oral cavity. Case report: Case of a 5 year 4 months old male patient with medical history of congenital hyperinsulinism. During the anamnesis, parents tell that the child ingest from 5 to 6 meals per day and has a high carbohydrate intake between meals in order to keep blood glucose levels. Through the examination of the child´s oral cavity were found carious lesions in several dental organs requiring different treatments. During dental care, the tell-show-do behavior management technique was used to avoid developing anxiety and stress in the child. Conclusion: Due to the multiple meals and high carbohydrate intake a strict regime regarding oral hygiene and, preventive measures, as well as regular visits to the dentist are necessary. In addition, it is essential to perform good behavioral management to avoid anxiety and stress during the treatment to prevent a hypoglycemic crisis.