Diabetes and Oral Health

People with diabetes have an increased risk of developing oral problems. Here are the most common dental issues related to diabetes and how to prevent or slow them down. 

Have you noticed that your mouth is very dry, you have some small sores, or your teeth bleed when you brush them? You are not alone, and it may be tied to your diabetes. A recent study stated that people with diabetes have a two-fold increased risk of developing periodontal disease compared to those without diabetes. 

Periodontal Disease

What is periodontal disease?

Periodontal disease is the destruction of the supporting tissue of the teeth and is the main cause of tooth loss in people with diabetes. 

Why does this happen?

• An increase in inflammation in the tissue
• Reduced blood delivery and return from the tissue
• Enhanced bacterial growth due to high glucose values
• Impaired wound healing

It is important to note that all of the above conditions are related to elevated glucose, not the diagnoses of diabetes. It is a two-way challenge. If you have periodontal disease, glucose is more difficult to manage, and when glucose is high, it results in the increased risk of periodontal disease. It is suggested that increased periodontitis may contribute to insulin resistance as well.

Dental Caries (Cavities)

Dental caries are also known as cavities. Diabetes itself does not appear to cause dental caries. That said, people with diabetes are more likely to develop cavities. 

Why does this happen?

• Consider treatment of hypoglycemia as one plausible cause. Consuming carbohydrates, particularly those that are sticky such as glucose chews, and those that stick to your teeth, like glucose tablets, are cariogenic (cause tooth decay). Rinsing after consuming these types of carbs, or even brushing your teeth, would reduce plaque buildup and help to prevent caries.
• Dry mouth can also contribute to dental caries. This could be a result of high glucose, or perhaps a medication not related to your diabetes. Check with your pharmacist to see if any medications you take could increase your risk for dry mouth and discuss management options such as small sips of water, chewing sugar free gum or other tools to reduce dry mouth.

Thrush

Thrush is an infection caused by a fungus that grows in the mouth. 

Why does this happen?

• High levels of glucose result in high levels in your saliva as well. High glucose levels increase the growth of candida (yeast) – responsible for thrush.

Signs and Symptoms of Dental Problems

What are the signs and symptoms of dental problems? 

• Red, swollen or bleeding gums
• Loose teeth
• Changes in the fit of your dentures
• Mouth sores (often white)

Prevention of Oral Problems

How can dental diseases be avoided?

• Manage glucose values within the target range of 70-180 mg/dl most of the time
• Brush twice a day and floss once
• Maintain a blood pressure within target (for most people with diabetes – 130/80 mm Hg or less)
• See your dentist every 6 months, or more frequently if recommended by your dentist – and let the dental office know you have diabetes
• If you smoke, QUIT!
• If you are concerned about any of the above signs or symptoms – see the dentist right away.

You can avoid having dental problems that are related to diabetes. Manage your glucose, brush your teeth, visit your dentist regularly and have a great smile for years to come!