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Most people are aware of how destructive a disease diabetes is to the various organs and parts of the body, such as the eyes, kidney, heart, and nerves. It is also extremely damaging to one’s teeth, the extent of which may be surprising. As with other parts of the body that are affected by diabetes, uncontrolled or poorly controlled diabetes can make oral problems worse. In fact, gum, bone, and tooth loss are all very real concerns for people who are suffering from this disease. Fortunately, by educating oneself about the risks and preventative measures, it is possible for diabetics to stay on top of their oral health and potentially prevent any permanent damage caused by having high blood sugar.
Dental Risks Associated with Diabetes
People with diabetes typically fall under two major categories, Type I or Type II. Additionally, some pregnant women are also at risk of developing a third type of diabetes called gestational diabetes. While the type of diabetes that a person has is important in terms of care, it is of little importance when it comes to the impact that the disease has on one’s teeth and gums. Even if one’s blood glucose is poorly controlled, he or she is still at risk of developing major dental problems regardless of whether their diagnosis is Type I or Type II. If blood glucose remains uncontrolled people can expect to suffer problems such as dental decay and gum disease.
The decay of one’s teeth is best known as cavities. The best way to understand the relationship between cavities and diabetes is to understand how tooth decay develops and how sugars in the mouth help it to happen. Inside of everyone’s mouth there are literally hundreds of bacteria. These bacteria take up residence on the surfaces of the mouth, such as one’s teeth, tongue, and gums. When sugar is in the mouth it feeds the bacteria causing a type of sticky film known as plaque to form. Each time a person eats any sugars or starches in the mouth interact with plaque to produce acids that attack the hard surface of the teeth, which is the enamel. Continuous and frequent acid attacks on the teeth can lead to the formation of cavities. When a person has diabetes with high glucose levels, there are greater amounts of sugar in the mouth to help aid the acid at wearing down at the enamel.
As noted, gum disease is another problem that is exacerbated by diabetes. There are two very important stages of gum disease that people should be aware of. The first of these stages involves a condition called gingivitis, which is the early stage of gum disease. As a diabetic, one’s ability to fight off bacteria is diminished. As a result a serious effort must be maintained in removing the bacteria or plaque in the mouth. If plaque is allowed to build up it can form tartar. Tartar, which is also known as calculus, is hardened plaque that builds on the teeth both above and below the gum-line. Dental calculus is more difficult to remove than regular plaque and its bacteria causes both irritates and damages the gums, resulting in gingivitis. At this stage, one might notice that their gums look swollen and that they bleed with brushing. When gingivitis is not properly treated a more advanced stage of gum disease occurs. Unlike with gingivitis, the damage caused by this more advanced stage is not reversible and can cause severe damage to one’s teeth. In fact, periodontitis eventually leads to destruction of the gums and bone, and may eventually lead to the loss of one’s teeth. In addition to the heightened risk of tooth loss, this advanced infection of the gums also affects one’s blood sugar by causing elevated blood glucose levels.
Diabetic Dental Care
Severe gum and dental damage up to the loss of one’s teeth is not an inevitable consequence of diabetes. People with diabetes can take measures to have a healthy mouth. To successfully maintain one’s teeth and keep one’s gums healthy people must dedicate themselves to a lifetime of properly managing their diabetes as well as their teeth. This means visiting one’s physician regularly and following his or her instructions in terms of medicine, diet, target blood sugar range, etc. It is also important for diabetics to inform their dentists of their medical condition and provide him or her with the contact information for the physician in charge of the patient’s diabetes care. This information empowers the dentist in giving patients the best care possible. It will also alert dentists to the need for twice yearly dental cleanings. People should not, however, wait for a reminder from their dentist to schedule these appointments. Mark a calendar or ask to schedule the next appointment in advance to ensure that an appointment is made.
Naturally, diabetics will want to closely follow routine oral hygiene guidelines. This means using a soft-bristled brush to clean the teeth at least twice daily – once in the morning and again at night before bed. If preferred an electric toothbrush can be an effective tool at cleaning the teeth. Additionally, it is also beneficial to brush between meals if and when possible. Daily flossing is also important to remove plaque and debris from between the teeth and under the gums. Waxed floss and a floss holder are useful tools to help make this an easier task. It can be helpful to regularly inspect the state of one’s gums for signs of disease. These signs include inflammation and bleeding. Changes in one’s mouth such as loose teeth, pain or sensitivity, and dryness should be reported to the dentist, along with any concerns about the gums. Diabetics who smoke are placing themselves at risk for serious complications. These complications affect the teeth and diabetes care in general.
- Diabetes: Dental Tips
- Good Oral Care is Important for Diabetics
- Dental Care and Diabetes… What’s the Connection? (PDF)
- Diabetes and Your Oral Health (PDF)
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