Diabetes and Oral Health

According to the American Dental Association, 21 million Americans have diabetes. Diabetes is a disease that affects the entire body. People with diabetes have a greater risk for health problems because they are unable to control their blood sugar levels. Uncontrolled blood sugar disables the white blood cells’ ability to fight infection. White blood cells are the body’s key defense to infection. Without them working at full capacity, you are at greater risk for infections of the mouth.  People with diabetes who smoke are 10 times higher to develop the following conditions because smoking hinders the blood flow to the gums, which interferes with healing.

Conditions commonly associated with diabetes: 

Dry Mouth – Low blood sugar decreases saliva flow and leads to dry mouth. The condition leads to sores, ulcers, and infections.

Gum Inflammation/Periodontal Disease – Aside from the other complications of diabetes, these people have a high risk for developing an advanced form of gum disease called periodontitis. Diabetes patients can reduce their risk of periodontitis by controlling their blood sugar levels. The mere presence of periodontitis will make your blood sugar harder to control as the disease causes infection in the body.

Diabetes impairs white blood cells, which thickens blood vessels, and ultimately slows down the flow of nutrients and other materials through the body. This causes infection and periodontal disease. Periodontal disease is a bacterial infection, and since diabetics are less able to fight infection, they will experience a more severe periodontal disease than non diabetics.   

Periodontitis causes your gums to pull away from your teeth. When this happens, pockets form between your teeth and gums. These pockets trap bacteria and germs, which eventually turn into puss. The more material that is in the crevices, the bigger they get. The only way to reverse periodontitis is oral surgery. If the condition is not treated, the teeth will decay to the point of requiring extraction and the remaining teeth will shift. In advanced cases of periodontitis, teeth have been known to simply fall out. 

Slow or poor healing in the mouth – People with diabetes, in general, heal slowly. This is due to the impaired blood flow that uncontrolled blood sugars causes. Even a simple cavity can be a major event for a diabetic.

Thrush – Diabetics are prone to fungal infections. One such fungal infection is called Thrush.  It develops in the mouth and tongue. Thrush thrives on the high sugar levels in the saliva when diabetes is uncontrolled.  Thrush also produces a burning sensation in the mouth and the tongue. 

The best way for diabetes patients to prevent these conditions is to control your blood sugar levels. There is a direct link between high glucose levels and oral disease. Develop healthy oral habits such as brushing regularly, flossing, and dental checkups twice per year. Don’t smoke. While smoking is not good for anyone, diabetes patients are several times as likely to develop smoking related conditions than non diabetic patients. 

Dental care and diabetes –It is imperative that diabetics stick to a good oral healthcare routine because they are at a higher risk for the diseases mentioned above. The first habit is to never miss a checkup visit. When identified early, infections and conditions of the mouth can be treated before they become a serious problem. At each visit, update your dentist on your diabetes condition and blood sugar levels. Share your diabetes doctor’s contact information prior to any oral procedures. Brush with a soft bristled toothbrush, floss regularly and have your teeth cleaned twice per year.

Common questions and myths about diabetes: 

Does diabetes increase the risk of cavities? 
The answer is yes and no. People with diabetes that control their blood sugar levels and have good oral hygiene are not at greater risk for cavities. When diabetics do not control their blood sugar levels, bacteria that cause cavities increases and the result is more cavities. In addition, since diabetics typically eat more meals throughout the day to control their blood sugar, they need to brush their teeth more frequently. In contrast, diabetics refrain from eating high sugar foods, which would put them at a lower risk than a non-diabetic person who eats those foods. As long as the disease is under control, the risk is mitigated.

Are diabetics at higher risk for complications when undergoing oral surgery? 
Diabetics are at greater risk when undergoing any surgical procedure because they heal slower and are at greater risk for infection. This risk is managed by administering antibiotics prior to the surgery and additional follow up visits after surgery to monitor the healing process. If the patient smokes, they must not smoke two weeks before and at least two weeks after oral surgery. Smoking increases the risk of infection in a non-diabetic patient. For diabetics, smoking increases the chance of infection ten times that of a non- diabetic person.

If you are diabetic, speak with your dentist about preventative measures that will ensure your oral health. Taking a proactive approach will save your teeth in the long run. The less damage you do to your teeth, the better off you will be down the road. You have only one set of teeth; treat them right!