Diabetes and Your Oral Health

Diabetes & Your Oral Health

When you have diabetes, special attention to your oral health is absolutely necessary!

Diabetes patients have an increased risk of oral infection, tooth decay, gum disease, and dry mouth conditions. If excellent oral health is not maintained, control of diabetes can be more difficult. If you are aware of the complications that diabetes can cause, your chances of maintaining a healthy mouth improve.

Tooth and gum damage

Diabetes causes an increased level of sugar in the blood, and this in turn can increase your chances of developing serious tooth decay.

Plaque

Plaque is a combination of bacteria and food particles that covers the teeth, cheeks, and tongue. The bacteria are fed by the food and produce acid as a byproduct. This acid attacks the teeth directly, causing tooth decay. Diabetics have a higher level of sugar in the blood, allowing the bacteria to produce more acid. This is why diabetics have a higher risk of tooth decay.

Gum disease

Dental plaque plays a large role in the formation of gum disease. If not removed from the teeth in 24 hours, it will harden and become very irritating to the gum tissues. This irritation turns into inflammation (gingivitis).

The inflammation is easily treatable by your dental professional. A dental cleaning and better brushing and flossing habits can clear it up in 2 weeks. However, if it is left untreated it can progress into a far more severe problem: gum disease (periodontal disease).

Periodontal disease develops when bacteria attack the bone supporting the teeth and infect the gum tissue. It eventually loosens the teeth, which may eventually fall out.

Diabetics are three times more likely than non-diabetics to develop gum disease. Once these infections arise, the body has a difficult time resolving them.

Research suggests that people with gum infections are more likely to experience cardiovascular problems. Bacteria from the mouth enter the blood stream, causing an inflammatory response in the body, and this inflammation is linked to increased risk of stroke or heart attack.

Prevent tooth and gum infection by:

• Getting your teeth cleaned three times a year
• Brushing three times a day with an electric toothbrush
• Flossing every day
• Examining your mouth for signs and symptoms of disease

Other Complications from diabetes

Diabetes may cause other complications beyond your teeth and gums. If you have any of the following symptoms, contact your dentist immediately!

Dry Mouth

Dry mouth (xerostomia) is a condition where the salivary glands fail to produce enough saliva. This may cause difficulty with speech, eating, and swallowing, and may cause your gum tissue and tongue to become sore and irritated.

Your dentist may recommend that you use artificial saliva products, moisturizing mouthwashes, or sugarless mints that stimulate saliva. Taking frequent sips of water also helps to maintain mouth moisture.

Fungal infection (Candiasis)

The mouth maintains a delicate balance of good and bad bacteria. When salivary flow is diminished, the balance is thrown off and an infection called Candiasis or oral thrush may develop. It usually shows as red and white areas. Your dentist will prescribe an antifungal. Certain things such as smoking or persistent denture wear increase your chance of developing a fungal infection.

Oral lichen planus

Oral lichen planus is a disorder that causes painful ulcers in the mouth and eroding of the oral tissues. There is no known cure for this disorder. Your dentist may prescribe a topical mouthwash to ease the discomfort.

Burning mouth syndrome

Burning mouth syndrome is characterized by a severe burning sensation in the mouth. Your dentist may prescribe a soothing mouthwash to diminish the symptoms. Two very likely causes of this syndrome are dry mouth (xerostomia) or candidiasis (fungal infection).

Oral surgery and Diabetes

Diabetes can cause delayed healing after oral surgery and if your diabetes is poorly controlled you are at an increased risk of oral infection.

Both post-surgery discomfort in relation to food consumption, and the stress of surgery can cause fluctuation in glucose levels. But maintaining glucose levels after surgery is important for reducing the risk of post-surgery complications, so diabetics must be especially aware of their glucose level after surgery.

Always follow the recommendations of the American Diabetes Association:

• Talk to your dentist. Discuss your condition with your dentist, and discuss ways to prevent infection.
• Eat before surgery. The best time for any dental procedure is when your blood sugar is under control.
• Don't skip your medications. Continue your medications unless directed otherwise by your physician.
• Eat soft foods. After oral surgery, plan to eat foods that do not cause your mouth any pain.
• Have controlled blood sugar. If your blood sugar is uncontrolled talk to your dentist about rescheduling for a different date.

Antibiotics and your Mouth

Why do I require antibiotics before my dental visit? During any invasive dental treatment, bacteria can be introduced into the blood stream. This poses a serious threat to anyone with heart abnormalities because the bacteria may cause inflammation of the heart (endocarditis) or surrounding tissues. Taking antibiotic medication before dental treatment significantly reduces your risk of developing this inflammation.

What types of heart abnormalities need to be considered?

There are many conditions associated with endocarditis. Your physician or cardiologist will determine whether or not you require antibiotic pre-medication. Some conditions that require it are:

• Heart surgery within past six months
• Pacemaker
• Vascular surgery (replaced artery) within past six months
• Artificial heart valve
• History of rheumatic fever
• History of heart murmur (mitral valve prolapse)
• Previous bacterial endocarditis
• Systemic pulmonary shunt
• Congenital heart defect
• Acquired valvular dysfunction

If any of these conditions apply to you, please consult your dentist before any dental treatment.

Who determines antibiotic pre-medication?

Your dental office follows the recommendation of the American Heart Association. This organization determines who requires these antibiotics, what the dosage is, and when it should be taken.

What about a joint replacement?

For the first two years after joint replacement, all patients should be pre-medicated for dental work. After the two years, your orthopedic surgeon will make the determination and your dentist will follow it. The goal is to avoid having the bacteria in the mouth introduced into the blood stream, from which they could attach themselves to the artificial joint.

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