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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.

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.

Age

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.

Genetics

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

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.

Medications

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