Diabetes and Dental Care

Diabetes is a disease  that can affect the whole body, including your  mouth. Dental  care is particularly important for people with  diabetes because  they face a higher risk of oral  health problems due to their poorly controlled blood sugars. The less well controlled the blood sugar is, the more  likely are oral health problems to arise. This is because  uncontrolled diabetes impairs white blood cells, which are the body’s main defence against bacterial infections  that can occur in the mouth.

Research also suggests that there is a two-way  relationship between serious gum disease and diabetes. Not only  are people with diabetes more susceptible to serious gum disease, but serious gum disease may also have the potential to affect blood  glucose control and contribute  to the progression  of diabetes. It has been proved that people with diabetes are usually  at higher risk for oral health problems, such as gingivitis (an early stage of gum disease) and periodontitis (serious gum disease). People with diabetes  are at an increased risk  for serious gum  disease because  they are generally more susceptible to bacterial infection, and have  a decreased ability to fight bacteria that invade the gums.

Research has emerged that suggests that the relationship  between periodontal disease  and diabetes goes both ways – periodontal  disease may make it more difficult for people  who have diabetes to control their blood sugar.

Severe  periodontal disease can increase  blood sugar, contributing to increased periods  of time when the body functions with a high blood sugar. This puts diabetics at increased risk  for diabetic complications. Thus, diabetics who have periodontal disease  should be treated to  eliminate the periodontal infection.

Therefore, if your blood glucose levels are  poorly controlled, you are more likely to develop  serious gum disease and lose more teeth than  people who have no diabetes. Like all infections, serious gum disease  may be a factor in causing blood sugar to rise  and may make diabetes harder to control.

What dental problems are associated with people with diabetes ?

People  suffering  from diabetes face a higher risk  of problems  associated to it such as :

·               Dry mouth, Uncontrolled diabetes can decrease saliva flow, resulting in dry  mouth. Dry mouth  can further lead to  soreness, ulcers, infections, and tooth decay.

·               Gum inflammation (gingivitis and periodontitis). Besides  impairing white blood  cells, another complication of diabetes is that it causes blood vessels to thicken, which slows down the flow  of nutrients to, and waste products from, body tissues, including  the mouth. When this combination of happens, the body’s ability to fight infections is reduced. Since periodontal disease is a bacterial  infection, diabetics with uncontrolled disease may experience more frequent  and more severe gum disease.

·               Poor healing of oral tissues. People  with uncontrolled diabetes do not heal quickly after oral surgery or other dental procedures because  blood  flow to the treatment site can be impaired.

·               Oral Thrush. People  with diabetes who frequently take antibiotics to fight various infections are especially prone to developing a  fungal infection of the mouth and tongue that forms  white, sore patches inside  the mouth. The fungus thrives on the high   glucose levels in the saliva of people  with uncontrolled diabetes.

·               Burning mouth and/or tongue. This condition is caused by the presence of thrush.

All the above oral ailments are caused  by infection and all are made worse by diabetes. And all are capable of driving blood  glucose levels out of the normal  ranges. Because of the increased potential  for infection due to  diabetes, patients with diabetes may require  visits to a diabetic dentist as often as four times a year.

People with diabetes who smoke are at even a higher risk – up to 20 times more likely than nonsmokers – for the development  of thrush and periodontal disease. Smoking also  seems to  impair blood flow to the gums – which may affect wound healing in this tissue area.

Dental care for people with diabetes.

Since people with diabetes are more prone to conditions  that may harm their oral health, it’s essential to follow  good dental care practices  and to pay special attention to any changes in your oral health  and to seek  a prompt dental advice if such  changes occur. Here are some points to consider:

·               Keep your blood  sugar as close to normal as possible.

·               At each visit  to the dentist, tell your  dentist about the status  of your diabetes. For instance, the dentist may want to know  your glycosylated hemoglobin (HgA1C) level to determine how  well controlled your diabetes  is (good control  is indicated by a level under 7%). If you’ve had a hypoglycemic  episode in the past (low blood sugar, also called an insulin reaction), you are at increased risk to have another one. Tell your dentist when your last  episode  was, how frequently  such episodes occur, and when you took your last dose of insulin (if you take insulin).

·               See your diabetes doctor before  scheduling  treatment for periodontal disease. Ask your doctor to talk to your dentist or periodontist about your overall medical condition before  any dental treatment  is performed. If  oral surgery is planned, your doctor  or dentist will tell you  if you need to take any pre-surgical antibiotics or need to change your meal schedule  or the timing and dosage of your insulin (if you take insulin).

·               Make sure to give your  dentist your diabetes doctor’s name and phone number to include  on your personal file. This information will then be readily accessible by your dentist should any questions or concerns arise.

·               Bring your dentist a list of all the names  and dosages  of all medications you are taking. Your dentist will need  to know this information  to prescribe medications least likely to interfere  with the medications you are already taking  if medications are needed. If a  major infection is being  treated, your  insulin dose (for those taking insulin) may need to be  adjusted. Check with your doctor.

·               Postpone nonemergency dental care  procedures if your blood sugar  is not in good control. However, acute infections, such as abscesses, should  be treated right away.

·               Keep in mind  that healing may take longer in people with diabetes. Follow  your dentist’s post-treatment instructions closely.

·               People  with diabetes with orthodontic appliances (such as  braces) should contact  their orthodontist immediately if a wire or bracket results in a cut to their tongue or mouth.

Day-to-day oral health  care tips

·               Have your teeth and gums cleaned and checked by your dentist twice  a year. (Your dentist may recommend a closer interval  depending upon your condition.)

·               Prevent  plaque buildup  on teeth by using dental floss  at least once a day.

·               Brush your teeth after every meal. Use a soft-bristled toothbrush.

·               If you wear  dentures, remove them and clean them daily.

·               If you smoke, talk to your doctor  about ways to quit.