Diabetes is a disease that can affect the entire body, including the mouth. People with diabetes are at higher risk of developing oral health problems than the general population.
Why are People with Diabetes Develop Oral Health Problems?
The link between diabetes and oral health problems is high blood sugar levels. If blood sugar levels are not properly controlled, oral health problems are more likely to develop. This is because uncontrolled diabetes weakens white blood cells, which are the body’s main defense against bacterial infections that can occur in the mouth.
Studies have shown that regulating blood sugar levels reduces the risk of developing serious organ complications from diabetes, such as eye, heart, and nerve damage, and diabetes may protect against the development of oral health problems.
What Oral Health Problems are Associated with Diabetes?
People with diabetes are at increased risk for:
- Dry mouth: Uncontrolled diabetes can lead to decreased salivary flow, which can cause dry mouth. Dry mouth can lead to pain, ulcers, infections, and cavities.
- Inflammation of the gums (gingivitis) and periodontitis: In addition to the weakening of white blood cells, another complication of diabetes is the thickening of blood vessels. This slows the flow of nutrients and waste products out of body tissues, including the mouth. This combination of factors makes it difficult for the body to fight infections. Because periodontitis is a bacterial infection, people with uncontrolled diabetes may experience periodontal disease more frequently and more severely.
- Poor healing of oral tissues: People with unrestrained diabetes may have a slow recovery from oral surgery or other dental procedures due to the potential decrease in blood flow to the treated area.
- Young people: People with diabetes who frequently take antibiotics to combat various infections are especially susceptible to developing fungal infections in the mouth and tongue. The fungus thrives due to the high glucose levels in the saliva of people with uncontrolled diabetes. Wearing dentures (especially permanent ones) can also cause fungal infections.
- Burning in the mouth and/or tongue: This condition is caused by oral thrush.
- People with diabetes who smoke have an even higher risk of developing oral thrush and periodontal disease—up to 20 times higher than nonsmokers. Smoking also appears to affect blood flow to the gums, which can impair wound healing in this area of tissue.
Prevention
If I have diabetes, how can I prevent oral health problems?
Since people with diabetes are more susceptible to diseases that can harm their oral health, it is important to practice good oral hygiene, pay close attention to any changes in their oral health, and contact your dentist immediately if they occur.
Some tips to prevent or reduce oral health problems include:
- Keep your blood sugar levels as close to usual as possible. At every dental visit, inform your dentist about your diabetes status. For example, know your glycated hemoglobin (HgA1C) level. (Good control is considered less than 7%.) If you have had an episode of hypoglycemia (also called an insulin reaction) in the past, you are at higher risk of experiencing another episode. Tell your dentist when your last episode was, how often you have had them, and when you last took insulin (if you use it).
- Consult your doctor before planning periodontal treatment. Ask your doctor to discuss your general health with your dentist or periodontist. If you are having oral surgery, your doctor or dentist will tell you if you need to take antibiotics before surgery, if you need to change your diet, or if you need to adjust the timing and dosage of your insulin (if you use it).
- Be sure to provide your dentist with your doctor’s name and phone number. This information will be available to your dentist if you have any questions or concerns.
- Bring a list of the names and dosages of all your medications to your dentist. Your dentist will need this information to prescribe medications that are least likely to interfere with the ones you already take. If you are treating a serious infection, your insulin dosage may need to be adjusted (for those using insulin).
- Postpone elective dental procedures if your blood sugar level is not well controlled. However, acute infections (those that develop quickly), such as abscesses, should be treated promptly.
- Keep in mind that healing may take longer in people with diabetes. Carefully follow your dentist’s instructions after treatment.
Contact your orthodontist immediately if a wire or bracket (such as orthodontic braces) cuts your tongue or mouth.
Other oral hygiene tips for people with diabetes:
Have your teeth and gums cleaned and checked at least twice a year. Consult your dentist to determine how often you need checkups.
- Prevent plaque buildup by flossing at least once a day.
- Brush your teeth after every meal. Use a soft-bristled toothbrush.
- If you wear dentures, remove them and brush them daily.
- If you smoke, consult your doctor about quitting smoking.
Prevention
If I have diabetes, how can I prevent oral health problems?
Since people with diabetes are more susceptible to diseases that can harm their oral health, it is important to practice good oral hygiene, pay close attention to any changes in your oral health, and contact your dentist immediately if they occur.
Here are some tips to prevent or reduce oral health problems:
- Keep your blood sugar levels as near to normal as likely. Inform your dentist about your diabetes at every dental visit. For example, know your glycated hemoglobin (HgA1C) level. (A level below 7% is considered good control.) If you have had an episode of hypoglycemia (also called an insulin reaction) in the past, you are at higher risk of having another episode. Tell your dentist when your last episode was, how often it occurred, and when you last took insulin (if you use it).
- Consult your doctor before planning treatment for periodontal disease. Ask your doctor to discuss your general health with your dentist or periodontist. If you are having oral surgery, your doctor or dentist will tell you if you need to take antibiotics before surgery, if you need to change your diet, or if you need to adjust your insulin schedule and dose (if you use it).
- Be sure to provide your dentist with your doctor’s name and phone number. This information will be available to your dentist if you have any questions or concerns.
- Bring a list of the names and doses of all your medications to your dentist. Your dentist will need this information to prescribe medications that are least likely to interfere with those you are already taking. If you are treating a serious infection, your insulin dose may need to be adjusted (for those using insulin).
- Postpone elective dental procedures if your blood sugar level is not well controlled. However, acute infections (those that develop quickly), such as abscesses, should be treated promptly.
- Keep in mind that healing may take longer in people with diabetes. Carefully follow your dentist’s instructions after treatment. Contact your orthodontist immediately if a wire or bracket (such as orthodontic braces) cuts your tongue or mouth.
Clean and check your teeth and gums at least twice a year. Consult your dentist to determine how often you need checkups.
- Prevent plaque buildup by flossing at least once a day.
- Brush your teeth after every meal. Use a soft-bristled toothbrush.
- If you wear dentures, remove them and brush them daily.
- If you smoke, consult your doctor about quitting smoking.
Conclusion:
In conclusion, the association between oral health problems and diabetes is significant and bidirectional. People with diabetes are at improved risk of developing oral health problems such as periodontic disease, dry mouth, and infections due to elevated blood sugar levels and a weakened immune system. On the other hand, poor oral health, especially periodontal disease, can negatively affect glycemic control, making diabetes management difficult. This highlights the position of a comprehensive approach, in which physicians and dentists collaborate to help patients manage both their oral and general health. Regular dental checkups, good oral hygiene, and effective glycemic control are essential strategies for breaking this cycle and improving the overall health of people with diabetes.