Dental care and diabetes: The importance of a healthy mouth

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Dental care and diabetes: The importance of a healthy mouth
February 18, 2005
From MayoClinic.com
Special to CNN.com
If you have diabetes, elevated blood sugar levels can damage many parts of your body Û and your mouth is no exception. Diabetes increases your risk of cavities, gum disease and tooth loss, dry mouth, and a variety of infections.
Conversely, poor oral health can make your diabetes more difficult to control. Infections may cause your blood sugar to rise and require more insulin to keep it under control.
Blood sugar tests: What's normal?
Improve your chances of keeping sound teeth and a healthy mouth Û be aware of potential oral complications, keep your teeth and gums clean, and maintain good control of your diabetes.
Tooth and gum damage: Diabetes can take steady toll
Day in and day out, high blood sugar caused by diabetes can contribute to accumulating damage to your gums and teeth, which may cause tooth loss. Here's how it happens.
Plaque: How diabetes feeds this cavity-causing menace
An invisible film of bacteria, saliva and food particles (dental plaque) normally covers teeth. The bacteria feed on the sugars and starches in the foods and beverages you consume and produce acids that damage the hard enamel coating of your teeth.
High blood sugar levels in diabetes give the bacteria a greater supply of food, allowing them to produce even more acid. The damage from this acid increases the possibility of tooth decay (cavities).
Gum disease: From irritation to tooth loss
Plaque can cause other problems, too. If you don't remove it from your teeth with regular brushing and flossing, it hardens under your gumline into a substance called tartar.
Tartar irritates the gums, causing a condition called gingivitis. This makes the gums tender, swollen and red, and they may bleed when you brush your teeth. Fortunately, your dentist can prevent or treat gingivitis by removing tartar during a professional dental cleaning.
However, untreated gingivitis can lead to a more serious condition in which bacteria infect your gums and the bones around your teeth (periodontitis). This can cause your gums to pull away from your teeth and your teeth to loosen and even fall out.
Gingivitis and periodontitis are the most common oral complications of diabetes. If you have type 2 diabetes, you're three times more likely to develop gum disease than is someone who doesn't have diabetes. Diabetes lowers your body's resistance to infections and slows your ability to heal.
Gingivitis
Periodontitis
Diabetes and the rest of your mouth
Your teeth and gums aren't the only parts of your mouth at risk. The following problems also can occur Û and while you might not be able to totally prevent them, you can minimize the trouble they cause you.
Dry mouth
Dry mouth (xerostomia) occurs when your salivary glands don't function properly, leaving insufficient saliva in your mouth to keep it moist. The dryness can contribute to cavities and gum disease, because saliva helps wash away the bacteria that contributes to these conditions.
Dry mouth also causes tissues in your mouth to become inflamed and sore. You may find that chewing, tasting and swallowing are difficult. If this reduces your interest in eating, it can make controlling your diabetes more challenging, since you may not eat properly and keep your blood sugar in control.
Your dentist may suggest an artificial saliva substitute to relieve the discomfort from dry mouth. Sucking on sugar-free candy or chewing sugar-free gum and frequently drinking water also may help ease dryness.
Dry mouth
Fungal infections
Candida albicans is a fungus that normally lives inside your mouth without causing any problems. But when you have diabetes, the deficiency of saliva in your mouth from dry mouth Û and the extra sugar in the saliva that you do have Û can allow the fungus to cause an infection called candidiasis (thrush). Candidiasis appears as sore white or red areas in your mouth.
To treat the infection, your dentist or doctor can prescribe an antifungal medication that you let dissolve in your mouth, or one that you take in pill form.
Oral thrush
Burning mouth syndrome
If you have this condition, you may feel severe burning and pain in your mouth even though you don't see any problems in your mouth that could be causing it.
Dry mouth or candidiasis can cause burning mouth syndrome, so treating these conditions can alleviate the symptoms. Medications also may be prescribed to relieve the pain.
Burning mouth syndrome
Oral surgery and diabetes: A delicate mix
If you need oral surgery, know that diabetes Û particularly if your blood sugar is poorly controlled Û can complicate such surgery. Diabetes can slow healing and increase your risk of infection.
Your blood sugar levels also may be harder to control after oral surgery. The levels may fluctuate as a result of the stress of the surgery itself or because you're unable to eat your normal foods due to discomfort.
By taking extra care to keep your blood sugar levels under control before and after the surgery, you can help reduce the risk of such complications. Your dentist also may need to work closely with your doctor to minimize possible complications.
If you need oral surgery, follow the American Diabetes Association's recommendations:
Remind your dentist that you have diabetes. Also, discuss any problems you have with infections or with controlling your blood sugar.
Eat before your dental visit. The best time for dental work is when your blood sugar is in a normal range, which allows for better healing. If your blood sugar level is out of control when you have a dental surgery scheduled, you may need to postpone the procedure until it's in control.
Take your usual medications. Your dentist should consult with your doctor about whether you need to adjust your diabetes medications or take an antibiotic to prevent infection before dental surgery. Unless your dentist or doctor tells you to change your medication schedule, continue taking your medications.
Plan out your eating needs before surgery. If you're having any dental work done that may leave your mouth sore, plan to eat soft or liquid foods that will allow you to eat without pain and control your blood sugar levels.
Wait until your blood sugar is under control. It's best to have surgery when your blood sugar levels are within your goal range. If your dental needs are urgent and your blood sugar is poorly controlled, talk to your dentist and doctor about receiving dental treatments in a hospital or other setting where more medical professionals can keep better tabs on your recovery after surgery.
If you have diabetes, you likely know the need to take certain precautions to keep your body working properly. To enjoy better oral health Û which in turn can help keep your blood sugar in check Û also treat your teeth with extra care and see your dentist regularly.
Caring for your mouth: Tips for healthy teeth and gums
February 18, 2005

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