Diabetes & Dental Health

Prevention may prevent problems, especially if you have diabetes–a disease that harms your mouth, eyes, nerves, kidneys, heart, and other important systems in the body. Dental patients who have diabetes should inform their dentist about the condition so that he or she can provide the appropriate care to help you maintain your teeth and gums. Any medications you may be taking should be mentioned to your dentist.

Common problems associated with diabetes include:

  1. Salivary gland dysfunction, which can lead to dry mouth and increased risk for cavities (tooth decay)
  2. Risk of infection due to poor blood supply (periodontal disease)
  3. Tooth loss due to gum infection leading to bone loss
  4. Slower healing after dental surgery (extractions, gum surgery, implants)
  5. Burning mouth syndrome
  6. Taste impairment
  7. Yeast infection (oral candidiasis) and mouth ulcers (lichen planus)

If you have poor glucose control, you can expect poor teeth and gums. Poor sugar control leads to a greater risk of periodontitis, and the odds are worse for patients who are diabetic–periodontitis is increasingly harder to treat and you may lose your teeth. With diabetic treatment and well-controlled blood sugar, you can significantly decrease your risk of periodontal disease, even if you have Type 1 diabetes.

Periodontitis (chronic infection of any area around the tooth) is often hidden from view and can cause painful chewing, bone loss, and loosened and weak teeth, resulting in increased decay and tooth extraction.

Why?

  1. Changes in the Blood Vessels – When diabetic blood vessels thicken, the flow of oxygen and nutrients to the gums is reduced. This reduced flow slows the clearing of waste products and can weaken the resistance of gum tissue and bone structure, leading to infection.
  2. Lack of Good Regular Oral Hygiene – If sugary food particles are left on the teeth, this will allow the bacteria to break down the particles into plaque, which will eventually harden to calculus if not cleaned off. This contributes to gum irritation, resulting in bone loss and decay. Most diabetic patients require more regular cleanings in order to help maintain ideal oral health.
  3. Poor Diet – High amounts of sugar and unhealthy food increase the risk of diabetes and harm your overall well-being.
  4. Smoking – Smokers are 5 times more likely than nonsmokers to have gum disease. Diabetic smokers, age 45 or older, are 20 times more likely to get severe gum disease.

What can a diabetic patient do?

  1. Undergo consistent screenings on a regular base for diabetes and taking the medications as prescribed by your physician.
  2. Know your personal degree of diabetic control and communicate this with your dentist at each visit. 3. If periodontal treatment is needed, consult your diabetes doctor to communicate with the dentist or periodontist about your overall medical condition and the medication you take.
  3. Treat acute infections in your mouth, such as an abscess, regardless of glucose control difficulties, as these are considered a dental emergency.
  4. Control blood sugar with the successful treatment of periodontal infection.
  5. Maintain good oral home care, including regular flossing and proper brushing (at least 2 minutes), to keep the bacteria count low and remove the sugars from your mouth.
  6. Avoid a dry mouth by drinking plenty of water and chewing sugar-free gum to help stimulate the saliva flow.
  7. Make sure that your denture or partial denture fits well to avoid gum irritation, which can promote infection.
  8. Be sure you have a healthy meal in the morning before your dental appointment, take any required insulin, and discuss your condition with your dentist in advance.
  9. Maintain good nutrition and diet. This may include Vitamin C, which has been shown to improve collagen formation and promote healing, especially if gum surgery is indicated.
  10. It is recommended that patients with diabetes should schedule appointments first thing in the morning to allow time for anesthetic to wear off and to avoid disrupting your mealtimes.
  11. Discuss options such as saliva substitutes and fluoride rinses with your dentist to see if they would be appropriate for you.

Taking Care of Your Dental Health

Plaque Removal – If you want to keep your own teeth, plaque must be removed. In the early stage of plaque development, your dental hygienist, dentist, or periodontist will need to perform a deep-cleaning procedure to remove hardened plaque and infected tissue under the gum, and may smooth the damaged root surfaces of your teeth. This cleaning and smoothing will allow the gums to reattach to the teeth. Your dentist may tell you to use a special mouthwash or take an antibiotic to help control the infection. Brush and floss regularly to keep plaque from returning.

Periodontal Surgery – In the advanced stage of periodontitis, the periodontist will clean out the infected pocket and reshapes or replace the damaged tissues supported by the teeth.

Additional Oral Problems Linked to Diabetes

Thrush – Also known as oral candidiasis, thrush is a fungus infection caused by the overgrowth of candida albicans, a yeast-fungus that thrives on high glucose levels in saliva. The main reasons for the overgrowth are smoking and wearing dentures (especially all the time). Preventive tactics include tight glucose control, not smoking, and daily removal and cleaning of your dentures.

Dry Mouth – Saliva is the natural cleanser of the oral cavity. The risk of soreness, ulcers, infections, and tooth decay increases when there is little or no saliva to lubricate the mouth and help remove the bacteria and food buildup that cause plaque and tooth decay. Dry mouth may be a side effect of medication. There are more than 400 over-the-counter and prescription drugs that cause dryness of the mouth. These medications include cold medicine, high blood pressure, and depression medications. Let your health practitioner or dentist know if you feel your mouth is too dry. A different drug or the use of “artificial saliva” will help keep your mouth moist and protect your teeth.

Tips to Protect Your Teeth & Gums

Brushing – The single most successful way to keep your natural teeth is to maintain the habit of brushing your teeth twice a day and using dental floss either before or after you brush.

Home Control – Plaque (the buildup along the base of the teeth around your gums) is hard to see unless it is old and stained, or it can be seen with the help of a red “disclosing tablet,” which is available at grocery or drug stores.

Consult your dentist – Anyone, especially people with diabetes, should have their teeth checked at least every six months.

  • If you have any problem with your teeth, gums, jaw or mouth, do not wait for your next appointment. Make sure to see your dentist immediately.
  • It is well advised to remind your dentist at each visit that you have diabetes.
  • If you change dentists, again, it is well advised to make sure your new dentist knows that you have diabetes.
  • Frequent dental checkups will detect problems early on, when treatment is most effective.

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