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Dental Complications for People with Diabetes

October is Dental Hygiene month, so this is the perfect time to focus on your own dental health!

According to "Oral Health in America: A Report of the Surgeon General," the relationship between type 1 and type 2 diabetes and periodontal disease is often referred to as the "sixth complication" of the disease.

Diabetics are more prone to several oral health conditions, including tooth decay, periodontal (gum) disease, dry mouth, infection and tooth loss, a fact Defeat Diabetes Foundation has been pointing out for many years.

There are a number of reasons people with diabetes are at greater risk for complications with their oral health. Though, if your diabetes is under control, the effects on your oral health can be minimized. On the other hand, if your diabetes is out of control, the impact on your oral health can be significant.

People with diabetes can have:

• Dry mouth (xerostomia)
• Gum inflammation (gingivitis)
• Rapidly progressingperiodontal (gum) disease
• Poor healing of oral tissues
• Oral candidiasis (thrush)
• Burning mouth and/or tongue

Dry mouth (xerostomia) is a condition which can increase your risk of tooth decay because saliva is what washes away sugars and food particles in your mouth that are fuel for decay-causing bacteria.

Some recent studies have shown that people with uncontrolled diabetes have decreased salivary flow. Foamy saliva and unusually dry and irritated tissue inside the mouth are tell-tale signs of the condition.

In fact, some people are actually diagnosed as having diabetes by their dentists because of this condition! According to the American Dental Hygienist’ Association (ADHA), dental hygienists often detect diabetes symptoms during routine oral health ex­aminations.

Gingivitis and Periodontal Disease is a significant concern for people with diabetes because nearly 1/3 suffers some form of this complication. The word periodontal literally means "around the tooth". Periodontal Disease, or gum disease, is an ongoing inflammation from bacterial infection in the gums and bone around your teeth. This infection destroys the tissues that support the teeth, including the gums, the periodontal ligaments and the tooth sockets (alveolar bone). If not treated, this inflammation can destroy the bone around your teeth. This results in tooth loss. 75% of all adult tooth loss is due to periodontal infection.

Generally, periodontal disease is due to the long-term effects of plaque deposits which are a result of inadequate oral hygiene. Plaque is a sticky material made of bacteria, mucus, and food debris that develops on the exposed parts of the teeth. It is also a major cause of tooth decay. If plaque isn’t removed, it turns into a hard deposit called tartar that becomes trapped at the base of the tooth. Plaque and tartar irritate and inflame the gums. Bacteria and the toxins they produce cause the gums to become swollen, tender and infected.

However, several diabetes related factors also lead to high rates of periodontal disease among people with diabetes:

• Many kinds of bacteria thrive on sugars, including glucose. When diabetes is poorly controlled, high glucose levels in saliva may help germs grow and set the stage for gum disease.
• The thickening of blood vessels is a complication of diabetes that may increase risk for gum disease. Blood vessels deliver oxygen and nourishment to body tissues, including the mouth, and carry away the tissues' waste products. Thickened vessels slow the flow of nutrients into, and the removal of, harmful wastes out of the mouth. This can weaken the resistance of gum and bone tissue to infection.
• Uncontrolled diabetes impairs a particular white blood cell called neutrophils, which are one of the body’s main defenses against bacterial infection. Periodontal disease is a bacterial infection, which affects the gum tissue. People with uncontrolled diabetes are more likely to have it, and their conditions are likely to be more severe.

The Symptoms of gingivitis and/or periodontal disease include:

• Bleeding gums (blood on toothbrush even with gentle brushing of the teeth)
• Bright red or red-purple appearance to gums
• Gums that are tender when touched, but otherwise painless
• Mouth sores
• Swollen gums
• Shiny appearance to gums

Successfully treating severe periodontal disease can actually help improve glucose control because any type of infection may cause blood-sugar levels to rise.

Poor Healing of Oral Tissues. As previously mentioned diabetes can impact the flow of blood to the mouth. If you have uncontrolled diabetes, you may have problems healing quickly after oral surgery, or other dental treatment, because blood flow to the site can be impaired. It is important, if you are to undergo oral surgery, you try and schedule it at a time when you are in good glucose control and generally healthy. Also, be sure to inform your dentist that you have diabetes.

People with poorly controlled diabetes may also be at risk for a fungal infection called thrush, or oral candidiasis, which thrives on the sugar in your saliva. Oral candidiasis can also cause a burning sensation in your mouth, called burning-mouth syndrome or stomatodynia. The syndrome has other causes as well, but antifungal medication may help if it is caused by oral candidiasis.

There is no widespread agreement on whether people with diabetes, as a group, have more or less tooth decay than the general population. What is clear is that people with diabetes have many other reasons to pay attention to their oral hygiene.

 

 

 

 

 

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