Diabetes is a disease that can affect the whole body — your eyes, nerves, kidneys, heart, and other important systems in the body. It can also affect your mouth. People with diabetes face a higher than normal risk of oral health problems.
Why are people with diabetes more likely to develop oral health problems?
The link between diabetes and oral health problems is high blood sugar. If blood sugar is poorly 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.
Just as studies have shown that controlling blood sugar levels lowers the risk of major organ complications of diabetes — such as eye, heart, and nerve damage — so to can diabetes control protect against the development of oral health problems.
Specifically, what are some of these oral health problems?
People with diabetes face a higher risk of:
- Dry mouth — Uncontrolled diabetes can decrease saliva flow, resulting in dry mouth. Dry mouth can further lead to soreness, ulcers, infections, and tooth decay.
- Gum inflammation (gingivitis) and periodontitis — Besides weakening white blood cells, another complication of diabetes is that it causes blood vessels to thicken. This slows the flow of nutrients to and waste products from body tissues, including the mouth. When this combination of events, the body loses its ability to fight infections. Since periodontal disease is a bacterial infection, people with uncontrolled diabetes might experience more frequent and more severe gum disease.
- Poor healing of oral tissues — People with uncontrolled diabetes do not heal quickly after oral surgery or other dental procedures because blood flow to the treatment site can be damaged.
- Thrush — People with diabetes who frequently take antibiotics to fight various infections are especially prone to developing a fungal infection of the mouth and tongue. The fungus thrives on the high glucose levels in the saliva of people with uncontrolled diabetes. Wearing dentures (especially when they are worn constantly) can also lead to fungal infections.
- Burning mouth and/or tongue — This condition is caused by the presence of thrush.
People with diabetes who smoke are at an even higher risk — up to 20 times more likely than non-smokers to develop thrush and periodontal disease. Smoking also seems to impair blood flow to the gums, which might affect wound healing in this tissue area.
If I have diabetes, what do I need to do to keep my mouth and gums healthy?
Since people with diabetes are more prone to conditions that might harm their oral health, it’s vital to follow good oral hygiene practices, pay special attention to any changes in your oral health, and to call your dentist immediately if such changes occur.
Suggestions to prevent or reduce oral health problems include:
- Keep your blood sugar as close to normal as possible. At each dental visit, tell your dentist the status of your diabetes. For instance, know your glycosylated hemoglobin (HgA1C) level. (Good control is indicated by a level under 7 percent). If you’ve had an episode of low blood sugar (also called an insulin reaction) in the past, you are at increased risk to have another one. Tell your dentist when your last episode was, how frequently such episodes occur, and when you took your last dose of insulin (if you take insulin).
- See your doctor before scheduling treatment for periodontal disease. Ask your doctor to talk to your dentist or periodontist about your overall health condition If oral surgery is planned, your doctor or dentist will tell you if you need to take any pre-surgical antibiotics, if you need to change your meal schedule or the timing and dosage of your insulin (if you take insulin).
- Make sure to give your dentist your doctor’s name and phone number. This information will then be readily accessible by your dentist should any questions or concerns arise.
- Bring your dentist a list of all the names and dosages of all medicines you are taking. Your dentist will need to know this information to prescribe medicines least likely to interfere with the medicines you are already taking. If a major infection is being treated, your insulin dose (for those taking insulin) might need to be adjusted.
- Postpone non-emergency dental procedures if your blood sugar is not in good control. However, acute infections (infections that develop quickly), such as abscesses, should be treated right away.
- Keep in mind that healing might take longer in people with diabetes. Follow your dentist’s post-treatment instructions closely.
- Call your orthodontist immediately if a wire or bracket (such as those in braces) cuts your tongue or mouth.
Other oral hygiene tips for people with diabetes:
- Have your teeth and gums cleaned and checked by your dentist twice a year.
- Prevent plaque buildup on teeth by using dental floss at least once a day.
- Brush your teeth after every meal. Use a soft-bristled toothbrush.
- If you wear dentures, remove them and clean them daily.
- If you smoke, talk to your doctor about ways to quit.
Dr. Akanksha Awasthi