Diabetes and Your Smile

By Laura Martin, Case Western Reserve University School of Dental Medicine

Did you know that 29.1 million people living in the United States have diabetes? That’s 9.3% of the population. Approximately 1.7 million new cases are diagnosed each year—and 8.1 million people living with diabetes don’t even know they have it.

Diabetes affects your body’s ability to process sugar. All food you eat is turned to sugar and used for energy.

- In Type I diabetes, the body doesn’t make enough insulin, a hormone that carries sugar from your blood to the cells that need it for energy.

-In Type II diabetes, the body stops responding to insulin. Both cases result in high blood sugar levels, which can cause problems with your eyes, nerves, kidneys, heart and other parts of your body.

So what does this have to do with that smile of yours — and how can you protect it? First, it’s important to understand the signs of diabetes and the roles they play in your mouth.

The Symptoms of Untreated Diabetes

The warning signs of diabetes affect every part of your body. After a blood test, you may be told by a doctor that you have high blood sugar. You may feel excessively thirsty or have to urinate a lot. Weight loss and fatigue are other common symptoms. Diabetes can also cause you to lose consciousness if your blood sugar falls too low.

If diabetes is left untreated, it can take a toll on your mouth as well.

Here's how:

*You may have less saliva, causing your mouth to feel dry. (Dry mouth is also caused by certain   medications.)
*Because saliva protects your teeth, you’re also at a higher risk of cavities.
*Gums may become inflamed and bleed often (gingivitis).
*You may have problems tasting food.
*You may experience delayed wound healing.
*You may be susceptible to infections inside of your mouth.
*For children with diabetes, teeth may erupt at an age earlier than is typical.

Why People with Diabetes Are More Prone to Periodontal (Gum) Disease

All people have more tiny bacteria living in their mouth now than there are people on this planet. If they make their home in your gums, you can end up with periodontal disease. This chronic, inflammatory disease can destroy your gums, all the tissues holding your teeth and even your bones.

Periodontal disease is the most common dental disease affecting those living with diabetes, affecting nearly 22% of those diagnosed. Especially with increasing age, poor blood sugar control increases the risk for gum problems.  In fact, people with diabetes are at a higher risk for gum problems because of poor blood sugar control. As with all infections, serious gum disease may cause blood sugar to rise. This makes diabetes harder to control because you are more susceptible to infections and are less able to fight the bacteria invading the gums.

How Your Dentist Can Help You Fight Diabetes

Regular dental visits are important. Research suggests that treating gum disease can help improve blood sugar control in patients living with diabetes, decreasing the progression of the disease. Practicing good oral hygiene and having professional deep cleanings done by your dentist can help to lower your HbA1c. (This is a lab test that shows your average level of blood sugar over the previous three months. It indicates how well you are controlling your diabetes.)

Your Diabetes Dental Health Action Plan

Teamwork involving self-care and professional care from your dentist will be beneficial in keeping your healthy smile as well as potentially slowing progression of diabetes.

Here are  things you can do to for optimal wellness:

*Control your blood sugar levels by using your diabetes-related medications as directed.
* Changing to a healthier diet and exercising more can help. Good blood sugar control will also help your body fight any bacterial or fungal infections in your mouth and help relieve dry mouth caused by diabetes.
*Avoid smoking.
*If you wear any type of denture, clean it each day.
*Make sure to brush twice a day with a soft brush and floss correctly daily.
*See your dentist for regular checkups.

This artical first appeared in mouthhealthy.org

Gum Disease

Gum disease is an infection of the tissues that surround and support your teeth. It is a major cause of tooth loss in adults. Because gum disease is usually painless, you may not know you have it. Also referred to as periodontal disease, gum disease is caused by plaque, the sticky film of bacteria that is constantly forming on our teeth.

Here are some warning signs that can signal a problem:

* gums that bleed easily
* red, swollen, tender gums
* gums that have pulled away from the teeth
* persistent bad breath or bad taste
* permanent teeth that are loose or separating
* any change in the way your teeth fit together when you bite
* any change in the fit of partial dentures

Some factors increase the risk of developing gum disease. They are:

* poor oral hygiene
* smoking or chewing tobacco
* genetics
* crooked teeth that are hard to keep clean
* pregnancy
* diabetes
* medications, including steroids, certain types of anti-epilepsy drugs, cancer therapy drugs, some      calcium channel blockers and oral contraceptives

See your dentist if you suspect you have gum disease because the sooner you treat it the better!

The early stage of gum disease is called gingivitis. If you have gingivitis, your gums may become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by a professional cleaning at your dental office, followed by daily brushing and flossing.

Advanced gum disease is called periodontitis. Chronic periodontitis can lead to the loss of tissue and bone that support the teeth and it may become more severe over time. If it does, your teeth will feel loose and start moving around in your mouth. This is the most common form of periodontitis in adults but can occur at any age. It usually gets worse slowly, but there can be periods of rapid progression.

Aggressive periodontitis is a highly destructive form of periodontal disease that occurs in patients who are otherwise healthy. Common features include rapid loss of tissue and bone and may occur in some areas of the mouth, or in the entire mouth.

Research between systemic diseases and periodontal diseases is ongoing. While a link is not conclusive, some studies indicate that severe gum disease may be associated with several other health conditions such as diabetes or stroke.

It is possible to have gum disease and have no warning signs.
That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend upon the type of disease and how far the condition has progressed. Good dental care at home is essential to help keep periodontal disease from becoming more serious or recurring.

Remember: You don’t have to lose teeth to gum disease. Brush your teeth twice a day, clean between your teeth daily, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy smiles.


This article first appeared on MouthHealthy.org, an A.D.A. website