Is there a relationship between diabetes and oral health? Diabetes is a chronic disease that affects the way our bodies process sugar. We all have sugar in our blood, whether from food or naturally produced in our bodies. Sugar is used as fuel for our cells. It is transported from the blood stream to the cells by insulin produced by the pancreas. People affected by diabetes do not produce enough insulin, or their bodies are not able to use insulin correctly, so the sugar remains in the blood stream. According to the American Diabetes Association, the resulting elevated levels of sugar in the blood can cause problems with the eyes, the kidneys and the heart and can impair the body's ability to fight infection and to heal.
Diabetes and Other Oral Care Issues
People with diabetes are at a higher risk of oral problems due to the higher concentration of glucose in the saliva, the poor healing of oral tissue and sometimes the medications they take. They are also more susceptible to cavities, dry mouth, gum disease and thrush (a fungal infection that occurs in the mouth). Smoking can exacerbate the dangers of diabetes to oral health by further increasing the risks of these conditions.
The mouth naturally contains many types of bacteria. When sugars from foods mix with bacteria, plaque is created on the surface of the teeth. Plaque attacks the hard outer surface (enamel) of your teeth, leading to tooth decay (cavities). According to the American Diabetes Association, dry mouth may increase one's risk of cavities as well because there is less saliva present to wash away the germs and acids created by foods and because there are elevated levels of sugar present in the saliva. In some diabetic patients, dry mouth can occur from medications or during times when there are high levels of blood sugar. Chewing sugar-free gum or simply drinking more water will lessen dryness in the mouth.
According to the American Dental Association, the most common oral problem for people affected by diabetes is gum disease. Gum disease occurs when the plaque that is not removed hardens and accumulates over time. Your gums become red and swollen, and may bleed. This first stage of gum disease is called gingivitis. If left untreated, the gums will begin to pull away from the teeth creating pockets or spaces that become infected. As the infection spreads, it begins to break down bone and tissue that hold teeth in place. This is the second stage of gum disease, called periodontitis, which is far more serious. If left untreated, teeth may become loose and need to be removed. The American Diabetes Association warns that, if your diabetes is poorly controlled, you will heal more slowly and increase your chances of infection after dental surgery. This could cause recurring gum disease that is more severe and more difficult to treat. People with diabetes are not only more susceptible to gum disease, but serious gum disease may also affect blood glucose control and contribute to the progression of diabetes.
Due to the fact that diabetics are at higher risk for infection, they are more likely to be taking antibiotics. However, according to the American Dental Association, diabetics who take antibiotics for infection are especially at risk for thrush, a fungal infection in the mouth. Thrush makes white or red patches in the mouth, on the tongue and along the gums, causing sore spots that sometimes turn into open sores. Those with dentures should be especially vigilant in making sure their dentures are properly fitted and clean. If you suspect that you have a fungal infection, see your medical or dental health care professional as soon as possible.
Prevention and Improving Oral Health
The most effective ways to prevent oral health problems are to brush, to use an interdental aid, such as floss, and to visit your dentist regularly. You should brush your teeth at least twice per day and floss at least once per day. Your mouth should be at its cleanest right before going to bed. There is no disruption to the growing bacteria in your mouth while you sleep; therefore, this is the time that bacteria can do the most damage. If you are unsure how to brush or how to use an interdental aid, ask your dental health professional to show you the correct technique. You should go to your dental maintenance visits twice per year, but most diabetics require greater frequency.