According to the American Diabetic Association more than 25.8 million children and adults in the United States—8.3 percent of the population—have diabetes. Diabetes develops in people of all ages. However, there is higher frequency of development in African Americans and Hispanics. Diabetes is a disease that can affect the whole body, including your mouth.
Research shows that there is an increased prevalence of gum disease among those with diabetes, adding to the list of other complications associated with diabetes, such as heart disease, stroke and kidney disease. Emerging research also suggests that not only are people with diabetes more susceptible to serious gum disease, but serious gum disease may have the potential to affect blood glucose control and contribute to the progression of diabetes.
Because diabetes can lower your resistance to infection and can slow the healing process. The most common oral health problems associated with diabetes are:
•Periodontal (gum) disease
•Salivary gland dysfunction
•Fungal infections/Oral Candidiasis
•Lichen planus and lichenoid reactions (inflammatory skin disease)
•Infection and delayed healing
Your teeth are covered with plaque, a sticky film of bacteria. After meals, snacks, or beverages that contain sugars, the bacteria release acids that attack tooth enamel creating cavities.
When diabetes is not controlled properly, high glucose levels in saliva may help bacteria to increase. Plaque that is not removed can eventually (calcify) into calculus, or tartar. This can create conditions that lead to chronic inflammation and infection in the mouth.
Periodontal disease is an infection of the gum and bone that hold your teeth in place. Periodontal diseases often appear to be more frequent and more severe among persons with diabetes. Signs of Periodontal Disease are gingivitis/bleeding gums, bone loss, periodontal abscess, bad breath and tooth mobility.
Salivary Gland Dysfunction
Saliva helps wash away food particles and keeps the mouth moist. Without enough saliva, bacteria will increase. Dry mouth, or Xerostomia, is a common complaint among diabetic dental patients. Dryness irritates the soft tissue in the mouth, often making them inflamed and painful. This condition greatly increases the risk of tooth decay and periodontal disease. Some recommendations for dry mouth are using a saliva substitute for relief from discomfort, taking frequent sips of water, using melting ice chips and restricting intake of caffeine and alcohol.
Infections and Delayed Healing
Infection is a risk for the diabetic patient and can make it more difficult to control blood glucose levels. If you are having extensive oral surgery or even a simple extraction, the dentist may prescribe antibiotics to minimize the risk of infection. To help the healing process, blood glucose levels should be under control before, during and after surgery extractions.
Other oral conditions that can be associated with diabetes are Oral Candidiasis, a fungal infection in the mouth that appears to occur more frequently among persons with diabetes including those who wear dentures. Dentist may prescribe antifungal medications to treat this condition. Good oral hygiene is critical. Another is Lichen Planus, a skin disorder that presents oral manifestations. Lichen Planus involves painful lesions in the oral mucosa. There is no permanent cure, dentist may prescribe a topical anesthetic or other medication to reduce and relieve the condition.
There are easy steps you can take to protect your oral health if you have diabetes:
•First and foremost, control your blood glucose level. Then, take good care of your teeth and gums, along with regular checkups every six months.
•Brushing twice a day with fluoride toothpaste and cleaning once a day between your teeth with floss or an interproximal teeth cleaner helps remove plaque causing decay.
•Another simple step is to brush with toothpaste specially formulated for sensitive gums.
•People with diabetes have special needs and your dentist and hygienist are equipped to meet those needs. Keep your dentist and hygienist informed of any changes in your condition and any medication you might be taking. Postpone any non-emergency dental procedures if your blood sugar is not under control.
In general, people should have regular dental check-ups every six months starting as early as six months of age to educate the parents.
N. Blonda-Gil, D.D.S., has served as the director of the Dental Services for the Mount Vernon Neighborhood Health Center Network for more than 10 years.