Why Your Dentist Is Part of Your Diabetes Treatment Team

No one wants tender gums that bleed and pull away from loosening teeth, creating infections and bad breath. That is why good oral care is vital when you have type 1 or 2 diabetes.

Although anyone can develop gum disease there is a link between high blood sugar and increased incidence of periodontitis. Periodontitis (periodontal disease) is caused by bacterial infections that can eventually destroy attachment fibers and supportive bone that secure the teeth in our mouths.

People with diabetes also tend to have more serious cases of oral disease, which can trigger diabetic complications.

The Glucose and Periodontitis Link

The bacteria that cause gum disease thrive in sugary environments, and people with diabetes have more sugar in their mouths. This is why, along with good dental care, excellent glucose monitoring is the best periodontitis preventive.

People with fluctuating or chronically elevated blood sugar have the highest risk for periodontal disease and more difficulties if a mouth infection sets in. Increased glucose interferes with the body’s ability to heal infections.

On-going periodontitis can also make blood sugar control more problematic. A vicious cycle can occur where the body’s energy (glucose) and immune systems have a negative influence on each other. A severe infection may increase an individual’s insulin requirements, at least until the gum inflammation is healed. Sometimes, hospitalization is required.

Other Factors

  • Diabetes weakens collagen—an important element in our soft gum tissue and in tissue that connects tooth to bone.
  • Saliva washes sticky plaque residue—often the start of gum disease—off our gums and teeth. Some people with diabetes, because of neuropathy or certain medications, may experience a reduction in salivation (dry mouth). Talk to your doctor or dentist about treating this issue.
  • The incidence of dental problems is closely associated with eye problems such as retinopathy. Someone diagnosed with retinopathy, or other diabetic complication, is wise to have a thorough oral examination. Conversely, those diagnosed with periodontal disease should inform their physician since it may indicate diabetic complications.
  • Diabetics who wear dentures should have their soft mouth tissues checked annually by a dentist for sores or signs of fungal infection.

Preventive Care

Many diabetes experts recommend visiting the dentist twice each year, and to schedule appointments about 90 minutes post breakfast so it does not interfere with regular meal times. Adhere to your oral medication or insulin schedule on appointment day and discuss any changes in your diabetes condition or treatment with your dentist.

Regular brushing and flossing are essential. Your dentist can give you guidelines for both. Be sure to ask since some oral care fundamentals may surprise you. For instance, many dentists recommend brushing for at least three minutes, which is two minutes more than many of us usually give it.

You and Your Dentist

If you have diabetes, especially if you are insulin or oral medication dependent, you will want a good working relationship with a dentist sensitive to your needs:

  • Talk to your dentist about possible high or low blood sugar problems that might occur while you are in the dentist’s chair. Some experts recommend your dentist have a calibrated glucose meter, fruit juice or glucose tablets, and a glucagon kit on hand—and know how to use them.
  • Make sure your dental team is aware of low blood sugar signs (e.g., reduced coordination, sweating, shaking, blurry vision), and how to respond. Let your dentist know if you have hypoglycemic unawareness, or experience few (or no) symptoms of low blood sugar when it occurs.
  • Make sure your dental team can spot the symptoms of high blood sugar (e.g., dehydration, acetone breath, mental confusion) and knows to postpone the dental session if it occurs.

“You don’t have to brush your teeth – just the ones you want to keep.”
~ Author unknown (might be a dentist)

Source: Diabetes Health
Photo credit: Conor Lawless

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