Did you know there is a “closed loop” between your dental health, gum disease/health, and dental care and the worsening or improvement of your ability to successfully control your blood sugar levels? And did you know: all dentists are not equally prepared to assist diabetics with their dental health, periodontal care, implant dentistry or restoration after years of inadequate care, if needed?
Along with eyes, feet, skin, hearing and heart complications that can arise when someone has diabetes, the American Diabetes Association also lists oral health factors into the equation as well. Indeed, having poor gum health, under the gum line low-level infections, loose teeth or other dental problems can be a secret enemy fighting your efforts to manage your diabetes.
“Research shows that there is an increased prevalence of gum disease among those with diabetes,” warns the American Diabetes Association, which includes the dentist as a key member of the healthcare team when someone is living with diabetes.
Connections Between Treatment of Diabetes and Gum Disease
It’s very important for people who have diabetes symptoms to work closely with their dental treatment team to keep their teeth and gums in great shape. Unfortunately, however, not all dentists understand the connections between treatment of diabetes and gum disease, let alone knowing how to lower blood sugar.
Putting the problem in perspective, Mayo clinic experts list how oral health ties into a person’s overall health. Like all infections, serious gum disease may be a factor in causing blood sugar to rise and may make diabetes harder to control.
“Diabetes reduces the body’s resistance to infection – putting the gums at risk. In addition, people who have inadequate blood sugar control may develop more frequent and severe infections of the gums and the bone that holds teeth in place, and they may lose more teeth than do people who have good blood sugar control,” experts warn.
Research also suggests that the relationship between serious gum disease and diabetes is two-way. Not only are people with diabetes more susceptible to serious gum disease, but serious gum disease may have the potential to affect blood glucose control and contribute to the progression of diabetes.
People with diabetes are at higher risk for oral health problems, such as gingivitis (an early stage of gum disease) and periodontitis (serious gum disease) because they are generally more susceptible to bacterial infection, and have a decreased ability to fight bacteria that invade the gums.
Gum Disease (Periodontitis)
The American Dental Association lists systemic diseases, including diabetes, as a factor that can increase the risk of periodontal disease. Periodontitis involves the inflammation and infection of bones and ligaments that support the teeth.
Dentists should encourage diabetics to make sure they have periodontal charting or probing done. That process measures the space of the gums around a tooth. Two to 3 millimeters of space is in the normal range. The space deepens to 5-10 mm in someone with gum disease, and by 8-9 mm, teeth are getting mobile.
Many people have a misconception a tooth can just be replaced, but nothing functions as well as your own teeth. When someone has gum disease, it’s important to have cleanings more often. The process can include deep cleaning or surgery to treat gum disease.
According to the American Dental Association, plaque, a sticky film of bacteria, covers the teeth. After someone eats or drinks something that contains starch or sugar, the bacteria release acids that attack tooth enamel, and over time, the attacks can cause enamel to break down, which can lead to cavities.
Dry Mouth & Thrush
In addition to gum disease and tooth decay, other health conditions have connections to diabetes. For example, someone with diabetes might be prone to xerostomia (dry mouth), which also is a side effect with many medications, and candidiasis (thrush), an oral infection. Burning mouth syndrome is another condition that might affect someone who has diabetes.
When diabetes isn’t properly controlled, high glucose levels in saliva can create an environment favorable to these bacteria. The ADA recommends brushing twice a day and flossing daily to help remove plaque that could cause tooth decay.
Saliva contains enzymes and proteins that help control the bacteria in the mouth to help prevent oral infections, dental decay and gum disease. Yet for those with diabetes, higher sugar levels in the blood and saliva encourage bacterial growth.
Dental researchers say there also may be a link between xerostomia and the medications prescribed to treat diabetics. According to recent studies, three-fourths of those who suffer from diabetes also have high blood pressure, and most drugs used to treat hypertension can cause the salivary glands to produce less saliva. Dryness can also be intensified by the use of other drugs, such as antidepressants and antihistamines. For diabetics it is a vicious cycle, so it is important to use products specially formulated to treat gum disease and dry mouth.
Plaque & Tartar
Plaque that isn’t removed can harden into tartar. When tartar builds above the gum line, it becomes more difficult to brush well and to clean between the teeth. This can ultimately lead to chronic inflammation and infection. Diabetes isn’t caused by gum disease, but gum disease can make it worse and vice versa, say dental hygienists.
If members of the dental team don’t achieve the progress they expect with a patient, they might send him to have a full workup done to see what might be affecting how the dental treatment is going. When someone is having trouble controlling blood sugars, taking care of their dental situation results in improvements a lot of times.
Indeed, just removing plaque every six months can help a lot. Bacteria in the mouth is a concern because if it gets into you bloodstream through your mouth, it can go systemic. It’s important to let your dentist know if you have been diagnosed with diabetes.
Good oral health also plays a role in a person’s nutritional status, which has a significant impact on overall health. A diet high in carbohydrates, which break down into sugar, could affect a person’s likelihood of developing cavities. Tooth loss can also affect a person’s ability to eat.
Giving up cigarettes is equally important because tobacco smoke dries out the mouth, besides being linked to a number of other health risks, including cancers. Use of other tobacco products also tightens the blood vessels. You need blood flow into your mouth.
To prevent dental problems associated with diabetes, first and foremost, control your blood glucose level. Then, take good care of your teeth and gums, along with regular checkups every six months. To control thrush, a fungal infection, maintain good diabetic control, avoid smoking and, if you wear them, remove and clean dentures daily. Good blood glucose control can also help prevent or relieve dry mouth caused by diabetes.
Remember, whatever has kept you from getting the optimum, complete dental care you need in the past should not concern you now. Today’s methods can actually be virtually pain free; you can be assured of respectful, compassionate care in a relaxed environment, never any criticism for having put off treatment. And every dental problem has a solution.
Bottom line: Managing diabetes includes everything from nutrition to exercise to medication to dental health.
Sources: American Diabetes Association, American Dental Association, Mayo Clinic, Colgate