Understanding Diabetes and Oral Health
Diabetes isn't a choice, but we can choose the best strategy in which to fight it, especially when it comes to your dental health.
Nearly 30 million people battle diabetes and 23 seconds someone new is diagnosed with diabetes.
The Connection Between Diabetes and Oral Health
Diabetes and oral health conditions are often related. According to the National Institute of Dental and Craniofacial Research. Patients with Type I or Type II diabetes are at an increased risk of developing tooth decay, gum disease, dry mouth, and a variety of fungal infections in the mouth.
Fortunately, diabetics today can take a proactive approach to manage their oral health by following and controlling their glucose levels, practicing thorough oral hygiene and visiting the dentist on a regular basis for examinations and dental cleanings is important.
The immune system can easily become impaired when diabetes is not controlled. People with diabetes face a higher risk of oral health problems, such as:
Those with diabetes who often take antibiotics to fight various infections in their body are most prone to developing a fungal infection of the mouth or tongue. The fungus thrives on the increased glucose levels in the saliva of people with uncontrolled diabetes.
Wearing dentures, especially if worn continually can be a great contributor to fungal infections.
People with diabetes who smoke are at a much higher risk --- up to 20 times more likely than non-smokers to develop thrush and periodontal disease. Smoking also is believed to impair blood flow to the gums, which could negatively impact the healing around the tissue or wound areas.
A burning sensation in the mouth or tongue is caused by the presence of "thrush."
Unmanaged diabetes will often decrease saliva production which is the body's way of naturally rinsing the mouth of harmful bacteria, resulting in dry mouth. Dry mouth, if untreated leads to infections, tooth decay, ulcers, and soreness in the mouth, jaw, and sinus cavity.
Periodontitis, gingivitis (gum inflammation)
Another complication of diabetes if left unchecked is the weakening of white blood cells which results in the thickening of blood vessels. This results in slowing the flow of nutrients to and waste products from the body tissues, including the mouth. This combination of events makes it difficult for the body to fight off infections. Since periodontal disease is a bacterial infection, people with uncontrolled diabetes might experience more frequent and more severe gum disease.
Research also indicates that having a severe gum infection can make it much more difficult for diabetics to control blood sugar levels. If blood sugar is poorly managed, it is more likely that other oral health problems will arise.
Insufficient healing of oral tissues
Uncontrolled diabetes in a person can be a detriment to proper healing of the oral tissues from dental treatments or oral surgery. This is due to the lack of blood flow to the surgical or area of therapy.
Are people with diabetes at greater risk for dental cavities?
There are some who believe that high glucose levels in the saliva of people with unmanaged diabetes cause bacteria to thrive. This results in the development of gum disease and dental caries. Also, people with diabetes tend to eat more frequently throughout the day which increases the chance for bacteria to grow and more of an opportunity for cavities to surface.
There are others who believe that people with diabetes are more aware of what to manage their sugar intake and therefore don't eat many foods with cavity-causing sugar.
The fact is good oral hygiene and keeping a good blood sugar balance are the best protection against cavities and periodontal disease.
So what can diabetics do to keep their mouth and gums healthy?
Since people with diabetes are much more prone to infections and conditions that can be harmful to their oral health, it's vital to follow good oral hygiene practices and be attentive to any changes in your oral health. If changes are present, contact your dentist immediately.
Following are my recommendations to reduce or even prevent oral and dental health issues:
Postpone non-emergency dental procedures if your blood sugar is not in good control.
However, severe infections, such as abscesses, should be treated immediately.
Make your dentist aware of your condition.
Provide your dentist with your doctor's name and phone number. This will allow your dentist to readily contact your doctor regarding treatment or questions.
Before scheduling treatment for periodontal disease, see your doctor first.
Request that your doctor speak with your dentist regarding your overall health condition and to be sure they are both on the same page. If oral surgery is necessary, your doctor and dentist can discuss what you need to take for pre-surgical antibiotics, meal schedules that you may need to change, and dosage and timing of your insulin (if you are taking insulin).
Keep your blood sugar as close to normal as possible.
Make sure you take the initiative to inform your dentist on the status of your diabetes. For example, know your glycosylated hemoglobin (HgA1C) level. (Good control is indicated by a level under 7 percent). If you’ve had an incident of low blood sugar (also called an insulin reaction) in the past, you are at increased risk to have another one. Tell your dentist when your last occurrence was, how frequently such incidents occur, and when you took your last dose of insulin (if you take insulin).
Provide a list of the names of all the medications and the amount of dosages you are taking.
This will be beneficial to the dentist in prescribing medicines least likely to interfere with the medicines you are taking.
Follow carefully the treatment prescribed by your dentist.
Keep in mind that healing might take longer due to diabetes.
For those with braces, call your orthodontist immediately if a wire or bracket cuts your tongue or mouth.
Make sure to remind them you are a diabetic so that this is elevated and addressed immediately.
Have your teeth and gums cleaned and checked at least twice per year.
If you wear dentures, remove them and clean them daily.
Prevent plaque buildup on teeth by using dental floss at least once per day.
If you smoke, talk to your doctor and find a plan together that helps you quit.
Diabetes is a disease that can affect the entire body --- your eyes, heart, nerves, kidneys, and your teeth, gums, and mouth. With attention to medical care, awareness, and self-care that monitors and keeps blood sugar as close to normal as possible, and excellent personal and professional dental care, problems after dental treatments or oral surgery are no more likely in people with diabetes than in those without the disease.
DR. REZA KHAZAIE