Oral Effects of Diabetes
If you suffer from Diabetes it means you have too much glucose (sugar) in your blood. No matter what type of diabetes you have, this can lead to serious health issues.
Diabetes can affect the entire body. Whether diabetes affects your oral health depends on how well controlled your blood sugar level is. If your diabetes is under control, it should have little impact on your oral health. However, if your diabetes is not under control, your mouth may be at greater risk of certain diseases.
People with diabetes may experience:
- Burning mouth and/or tongue
- Dry mouth (xerostomia)
- Oral candidiasis (thrush)
- Gum inflammation (gingivitis)
- Periodontal (gum) disease affecting deeper structures
- Poor healing in the mouth
Uncontrolled diabetes affects your white blood cells, your main defence system against bacterial infections. Gum Disease is caused by bacteria, so people with uncontrolled diabetes may be more likely to experience gum disease. They may also experience more severe forms of gum disease. It is important to visit your dentist if you have noticed any signs of gum inflammation, such as bleeding when brushing. Successful gum treatment can also help stabilise diabetic control. Any type of infection may cause blood sugar levels to rise. This includes periodontal disease. If the infection is treated successfully, your blood sugar may go down, and you may need less medicine to control your diabetes.
The most important part of controlling gum disease is your daily oral hygiene routine. Your dentist or hygienist will advise you on a routine that is best suited to you.
Dry mouth (xerostomia) can increase your risk of tooth decay (cavities) and gum disease. Saliva normally washes away sugars and food debris that are fuel for bacteria that cause tooth decay. It also plays a role in defending the gums against bacteria that cause gum disease. People with uncontrolled diabetes may have decreased flow of saliva. If you suffer from dry mouth, brush twice a day with an antibacterial fluoride toothpaste and floss every day, your dentist or physician may suggest using artificial saliva or other means of moistening your mouth. Fluoride rinses may also be advised to help prevent tooth decay.
Uncontrolled diabetes can influence the body’s ability to heal, you may have problems healing quickly after oral surgery or other dental treatment. There are several reasons for the slow healing, which may be partly due to blood flow to the site.
You may also be at risk of a fungal (yeast) infection called thrush or oral candidiasis. This condition is treated with antifungal medication. Thrush can cause a burning sensation and/or a metallic taste in the mouth. Other conditions related to diabetes may also cause a burning sensation in the mouth. Your dentist or doctor can examine you and advise you on what to do.
At the Dentist
Regardless of how well your diabetes is controlled, it is important to keep your dentist informed about your condition. Your dentist is part of the health care team that look after you. Inform your dentist about any changes in your condition or your medicines. This information will help your dentist decide the best treatment for you. Tell your dentist about any changes in the type and/or amount of insulin you take. Also, be sure to let your dentist know about any reaction you have had to any medicine.
Your dentist may need to contact your doctor, it’s important that you provide up to date information in case the need arises for your dentist to consult on your care.
Your dentist may also need to know the results of some of your blood tests (for example, haemoglobin A1C and fasting blood glucose). This information helps your dentist to better understand the level of your diabetes control. In general, diabetics with a haemoglobin A1C level of less than 7% are considered to be well controlled. Levels above 8% indicate poorer control.
People with poorly controlled diabetes are at higher risks of infection and poorer wound healing. Because diabetes can affect your blood cell counts, it’s very useful to provide your dentist with a copy of your most recent blood tests.
If your diabetes is well controlled, you probably will not need any special dental care. This is true whether or not you require insulin to control your diabetes. People with poorly controlled or uncontrolled diabetes may need to take antibiotics before and after dental treatment that may put them at risk of a bacterial infection. For example: any form of gum surgery or tooth extraction. This is even more important for diabetics who also have heart or kidney problems.
Before visiting the dentist, make sure you take your insulin and eat normally. Your dentist will have a source of glucose, such as fruit juice, available in case your blood sugar levels drop. But you should also take a source of glucose with you to the dental surgery. After dental treatment, resume your normal diet as soon as your dentist advises you to. Your dentist will recommend what types of foods you may eat and when. This will depend on what dental treatment you have just had.
If you've had low blood sugar (hypoglycaemic) episodes in the past, tell your dentist how often they have occurred, how severe they have been, and when the last episode occurred. Low blood sugar occurs when your blood insulin level peaks. If you take insulin, make sure your dentist knows when you last took insulin and ate food.
Some medicines that may be prescribed by your dentist may interfere with your medications for diabetes. This is why it is important that your dentist knows the medicines you are taking and their doses.
People with diabetes tend to heal more slowly. They are also more prone to infections. Follow your dentist's instructions after treatment. This will help you to recover as quickly as possible.