Diabetes and Oral Care

Diabetes may affect the whole body, including your mouth. Dental care is essential for people having diabetes because they face a higher than normal risk of oral health issues due to poorly controlled blood sugars. Control of blood sugar is inversely proportional to oral problems, the less controlled blood sugar results in more oral health issues. This is because uncontrolled diabetes impairs white blood cells, which are the main defense against bacterial infections that can occur in the mouth.

Risk Factors

People with diabetes face a higher risk of:

  • 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 the flow of nutrients to and waste products from body tissues, including the mouth. When this combination of events 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.
  • 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. The fungus thrives on the high levels of sugar in the saliva of people with uncontrolled diabetes.
  • Burning mouth / tongue. This condition is caused by the presence of thrush.

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

diabetesCare Tips

Person having diabetes should take extra care of oral health. Some points to know are:

  • Control your blood glucose and maintain it to the lowest possible level
  • Brush and floss every day.
  • Visit your dentist regularly. Be sure to tell your dentist that you have diabetes.
  • Tell your dentist if your dentures do not fit right, or if your gums are sore.
  • Quit smoking. Smoking makes gum disease worse. Your physician or dentist can help you quit.

Keep an eye on your mouth problems. Note if gums bleed when they brush and floss or any dryness, soreness, white patches, or a bad taste in the mouth. If any sign seen, visit your dentist without any delay.

Dental Sealants and Tooth Decay

Dental sealant is a thin, plastic coating painted on the chewing surfaces of back teeth, the premolars and molars. The purpose of coating teeth with sealant is to avoid tooth decay. The sealant bonds into the depressions and grooves of the teeth and forms a hard shield that keeps food and bacteria from getting into the tiny grooves in the teeth and causing decay.

Using good technique of brushing and flossing can remove food particles and plaque from smooth surfaces of teeth. However, only brushing cannot always remove the food and plaque from all the niches and fissures of the back teeth. Sealants protect these vulnerable areas from tooth decay by “sealing out” plaque and food.

Need of Sealant

The most important reason for getting sealants is to avoid tooth decay. Fluoride in toothpaste and in drinking water protects the smooth surfaces of teeth but back teeth need extra protection. Sealants cover the chewing surfaces of the back teeth and keep out germs and food. Having sealants put on teeth before they decay will also save time and money in the long run by avoiding fillings, crowns, or caps used to fix decayed teeth.

Teeth Selection

Sealants are only applied to the back teeth, the molars and premolars. These are the teeth that have pits (small hollows) and fissures (grooves) on their biting surfaces. Dentist will tell you which teeth should be sealed after examining teeth and the fissures on them. Some teeth naturally have deep grooves which will need to be sealed; others have shallow ones which will not need sealing.

Dental Sealant Procedure

First of all, the tooth surface is thoroughly cleaned with a paste and rotating. Next the tooth is washed with water and dried. Then an acidic solution is placed on the fissured area of the tooth’s chewing surface for a number of seconds before being rinsed off. This creates small microscopic areas and a fine rougher surface than the surrounding tooth enamel. The rough surface and microscopic areas enable the dental sealant to attach to the tooth. After the tooth is dried again, the liquid dental sealant is placed on the tooth and hardened. Dental sealants are hardened by using a light that hardens the dental sealant, or sometimes by using a two-component dental sealant that sets without using a light. Once the dental sealant has hardened it becomes a hard plastic coating, and you can chew on the tooth again.

Sealant Life Time

Sealants usually last for many years, but your dentist will want to check them regularly to make sure that the seal is still intact. They can wear over time, and sometimes need to add or replace some sealant to be sure that no decay can start underneath it.

Risk Factors for Periodontitis

Periodontal disease is a serious disease which destroys teeth supporting bone and gum tissues. Teeth are supported by the gums, or gingiva and bone. A tooth’s root is affixed to the bone within its socket by fibers called periodontal ligaments. Gums are not cement attached to the teeth. A shallow, V-shaped gap called a sulcus exists between the teeth and the gums. Periodontal disease affects this gap to widen it. Eventually, in periodontal disease, the tissues supporting the tooth break down. If only the apparent gums are involved in this breakdown, the disease is referred to as gingivitis. If it is more advanced and involves the connecting tissues and bone, then it is called periodontitis.

The main cause of periodontal (gum) disease is plaque, but other factors affect the health of your gums.


Older people have the highest rates of periodontal disease.

Smoking/Tobacco Use

Tobacco users also are at increased risk for periodontal disease. Tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.


Research has indicated that some people may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be more likely to develop periodontal disease.


Stress also is a risk factor for periodontal disease. Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal diseases.


Some drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can affect your oral health.

Hormonal changes

Hormonal changes may also result in periodontal disease, such as those related to pregnancy or menopause

Clenching or Grinding Your Teeth

Clenching or grinding your teeth can put excess force on the supporting tissues of the teeth and could speed up the rate at which these periodontal tissues are destroyed.

Other Systemic Diseases

Other systemic diseases that interfere with the body’s inflammatory system may worsen the condition of the gums. These include cardiovascular disease, diabetes, and rheumatoid arthritis.

Poor Nutrition and Obesity

Because periodontal disease begins as an infection, poor nutrition can worsen the condition of your gums. In addition, research has shown that obesity may increase the risk of periodontal disease.

Symptoms of Gum Disease

Gum disease or periodontal disease, called Periodontitis, begins with bacterial growth in the mouth and may end with tooth loss due to destruction of the tissue that surrounds teeth. Gingivitis or gum inflammation usually precedes periodontitis. However, not all gingivitis progresses to periodontitis. In the early stage of gingivitis, bacteria in plaque buildup, causing the gums to become inflamed and to easily bleed during tooth brushing. Although the gums may be irritated, the teeth are still firmly planted in their sockets. When gingivitis is left untreated, it can advance to periodontitis. Toxins or poisons, produced by the bacteria in plaque, start to break down the bone and connective tissue that hold teeth in place. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth are no longer anchored in place, they become loose, and tooth loss occurs. Gum disease is the leading cause of tooth loss in adults.

Gum disease is often silent; symptoms may not appear until an advanced stage of the disease. However, warning signs of gum disease include the following:

  • Red, swollen or tender gums or other pain in your mouth
  • Bleeding while brushing, flossing, or eating hard food
  • Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before
  • Loose or separating teeth
  • Pus between your gums and teeth
  • Sores in your mouth
  • Persistent bad breath
  • A change in the way your teeth fit together when you bite
  • A change in the fit of partial dentures

Oral Cancer

Cancer is a disease of the cells of the body. Human body is made up from millions of tiny cells. There are many different types of cell in the body, and there are many different types of cancer which arise from different types of cell. What all types of cancer have in common is that the cancer cells are abnormal and multiply vigorously. Oral cancer is the growth of abnormal cells in any part of the lips, tongue, cheeks and throat. Most oral cancers start in the lining of the lips or mouth where you have thin, flat cells called squamous cells.

Avoid smoking and Alcohol

Factors that increase risk for oral cancer include, but not limited to, smoking and heavy alcohol use. Risk is multiplied if a person uses both smoking and alcohol. Other risk factors are being male, using marijuana, or having human papillomavirus (HPV). Oral cancer occurs more than twice as often in men as in women.

Symptoms for oral cancer include sores or lumps on the lips or in your mouth. Talk with your doctor if you have any of these signs:

  • Leukoplakia or erythroplakia
  • Sore on your lip or in your mouth that bleeds easily and does not heal
  • Lump or thickening on your lips, gums, cheek, or in your mouth
  • White or red patch on your gums, your tongue, tonsils, or the lining of your mouth
  • Sore throat or a feeling that something is caught in your throat
  • Unexplained difficulty chewing, swallowing, speaking, or moving your jaw or tongue
  • Numbness or pain in your tongue or other areas of your lips or mouth
  • Swelling in your jaw that makes your teeth loose or your dentures fit poorly
  • Changes in your voice
  • Dry mouth (Xerostomia)

Your dentist or doctor may look closely at your lips, mouth, or throat to check for signs of oral cancer. Other tests may be needed if there are possible signs of cancer, such as a biopsy, an X-ray, or an MRI.

Oral cancer is usually treated with surgery and radiation therapy. Your treatment will depend on the stage of your cancer and your other health factors. If the cancer is advanced, other treatments may be used. You may get chemotherapy. Or chemotherapy and targeted therapy may be used together.

Oral Fibroma : Cause, Prevention and Treatment

Fibromas are overgrowths of soft tissue. They appear as raised, relatively small areas. They commonly occur on the lips, inside the cheeks and on the tongue. Fibromas are usually pink. They also can be whitish or light-colored. If injured, fibromas may be reddish or bluish.Fibromas may develop because of constant irritation of the lips, the inside of the cheeks, or the tongue.


You may see or feel the fibroma. There are usually no symptoms. Fibromas may get bigger over time.


Your dentist will examine your mouth and ask you a few questions. Usually that will be enough for the dentist to diagnose a fibroma and determine a cause. A fibroma can be removed to confirm the diagnosis. In this case it should be examined in a lab to make sure it is not cancerous.


To avoid fibromas, avoid habits such as biting your lips or the inside of your cheeks. If you grind your teeth, ask your dentist to fit you with a night guard.


A fibroma will grow if the area continues to be injured. Fibromas that are large or interfere with speech should be removed.

When fibromas are removed, the tissue is sent to a laboratory for a biopsy. If you drink or smoke, your dentist is likely to order a biopsy to rule out oral cancer. Another reason to do a biopsy is if the fibroma has an unusual color. Fibromas are not known to become cancerous over time.

What is Plaque?

Plaque is a soft, sticky film that builds up on your teeth and contains millions of bacteria. The bacteria in plaque cause tooth decay and gum disease if they are not removed regularly through brushing and flossing.When you eat, the bacteria in plaque use the sugars in your food to produce acids that eat away at the tooth enamel. Repeated attacks cause the enamel to break down, eventually resulting in a cavity (or hole) in the tooth surface.

Plaque that is not removed daily by brushing and flossing between teeth can eventually harden into tartar. Brushing and flossing become more difficult as tartar collects at the gum line. As the tartar, plaque and bacteria continue to increase, the gum tissue can become red, swollen and possibly bleed when you brush your teeth. This is called gingivitis, an early stage of gum (periodontal) disease.

Fighting back against plaque

Plaque is colorless and difficult to see. Heavy plaque deposits can be easier to see and may look like a thick white deposit or food stuck to the teeth. If you’re not sure if you see plaque on your teeth, you can use a disclosing tablet or you can rinse with a few drops of food coloring in two ounces of water. The disclosing tablets or solution will temporarily stain the plaque so you can see it more easily. You can then brush and floss until the stain is gone.

Since plaque is constantly growing in your mouth, the best way to remove it and to prevent tartar build-up is to brush and floss your teeth every day.

  • Brush your teeth twice a day, using a soft-bristled toothbrush and fluoride toothpaste to remove plaque from tooth surfaces and protect your teeth from decay.
  • Clean between teeth daily (preferably before bedtime) with floss or an interdental cleaner to remove plaque from the places where your toothbrush can’t reach. Flossing is essential to preventing gum disease.
  • Since plaque is a sticky substance, you must brush and floss to help remove it. Mouth rinses alone will not provide enough plaque removal to keep your teeth and gums healthy.
  • Eat a balanced diet and limit between-meal snacks, which can provide more sugar for the bacteria in plaque to convert into decay-causing acids.
  • Visit your dentist at least once a year for professional cleanings and oral exams.

For further details take guidelines from your dentist. You may call Dr. Haddon Suttner for any type of dental problems on 02 9365 6197. For details about the services visit Dentist Bondi.

Tongue Infection

Tongue infection is very bothersome for a person suffering from it and often interferes with daily activities of life like eating, swallowing, speaking. The tongue mainly consists of muscles which are covered up with the mucous membrane. It has taste buds on its surface that enable us to taste the food that we eat. The tongue helps us in chewing and swallowing food. During communication, we use the tongue along with jaws and lips to produce words. When the tongue is infected, its appearance as well as function changes.

There are basically three types of tongue infections:

Viral infections:

The symptoms of a herpes infection of the tongue can vary, depending on how severe the infection is. The signs of a virus infection can range from small white spots (which are tiny blisters filled with highly infectious fluid) and a mild tingling, to painful larger blisters around the tongue. Left alone, the infection will heal up, but can be very painful. It’s better to seek some treatment from your dentist.

Fungal infections:

Fungal Infections are usually caused by “Candida Albicans”. This bug is normally present in the mouth, but at very low levels. During times of stress or a weakened immune system, the Candida gets a chance to spread and frequently sets up home on the tongue or cheeks.

Bacterial infections:

Bacterial infections can result from tongue piercing. It has been shown that metal studs, especially stainless steel, collect more bacteria than titanium or plastic studs. This build-up of bacteria on the stud can lead to a painful infection of the piercing.

Because this is a true bacterial infection, conventional antibiotics such as amoxycillin should work well. The cause of the infection – the stud – should be removed, cleaned in an ultrasonic bath and then sterilized in a vacuum autoclave.

Symptoms of a Tongue Infection:

The most obvious signs of all kinds of tongue infection are pain and swelling. These two symptoms make activities like chewing, swallowing and speech, a painful affair. In case of oral thrush, the tongue turns red and creamy, white lesions are found on its surface. The white patches caused by fungus may spread to the throat and esophagus as well. In some infections, the tongue gets blotchy and the patterns of the blotches keep changing from time to time. It is mostly accompanied by a burning pain in the tongue. Sometimes, bleeding may occur from the infected tongue

Remedies for Tongue Infections:

Gargling with warm, saline water several times a day is highly beneficial in this regard as the salt kills the infection causing pathogens thriving inside the mouth. Maintaining a good oral hygiene is a must when you are going for tongue piercings. The injury and swelling caused by tongue piercing can be managed by sipping warm water after frequent intervals.

Most of the causes of tongue infections can be controlled to a large extent with the help of proper oral hygiene. During this time, one should eat soft food that can be swallowed quite easily. Acidic foods or drinks should be strictly avoided as they can aggravate the symptoms.

For further details take guidelines from your dentist. You may call Dr. Haddon Suttner for any type of dental problems on 02 9365 6197. For details about the services visit Dentist Bondi.