Teeth and Diabetes

Guest Post from David Mapletoft, Diabetes Educator

Do people living with diabetes have more problems with the teeth than others?

Although a number of oral disorders have been associated with diabetes mellitus, the data support the fact that periodontitis is a complication of diabetes.

“People with diabetes who keep their blood glucose levels in a target range have no more dental problems than the rest of the population,” says Dr. Carol Alexopoulos, a dentist who practices in Canada.

However, people living with long standing, poorly managed diabetes are at risk of developing oral candidiasis, and the evidence indicates that periodontitis is a risk factor for poor glycemic control and the development of other clinical complications of diabetes.

The best predictor for severe periodontal disease in subjects with T2D is smoking followed by HbA1c levels. T2D subjects should be informed about the increased risk for periodontal disease when suffering from T2D according to this study 

Regular above target blood glucose levels can also lead to a decrease in saliva and an increase in salivary sugar, which leads to dry mouth, ulcers, fungal infections, increased tooth decay, loss of teeth, and difficulty wearing dentures.

Insufficient moisture can cause both dry mouth and a burning sensation on your tongue. This lack of moisture can eventually lead to an irritation of the entire lining of the mouth, since normal volumes of saliva actually protect your teeth from cavities and make chewing and speech comfortable. If you wear dentures and develop a feeling of dry mouth, you may find them irritating and more difficult to wear.

In addition, poorly managed blood glucose (sugar) levels can lead to:

• Severe toothaches due to impaired circulation to your teeth. If you cannot eat solid food because chewing is difficult, try alternatives such as milk, soup, cereals, pudding, or fruit juices to replace your carbohydrate allowance.
• More severe gum disease and at an earlier age.
• Thickening of the small blood vessels of the gingiva (gums) which can lead to infection of the gum and bone tissues.
• Periodontal disease that, in turn, can make it hard to manage blood glucose levels. Because periodontal disease is an infection, bacteria produce toxins that affect the carbohydrate metabolism in individual cells. It is also thought that the host response to periodontal bacteria can increase insulin resistance and, therefore, blood glucose levels.
• A narrowing of the blood vessels including those in the mouth which can reduce blood supply to the gums therefore increasing the risk of infection
• A gathering of sugars in the gingival fluid (the fluid between the tooth and gums) which can increase your risk of developing dental cavities.
• Fungal mouth infections such as thrush. Thrush appears as white (sometimes red) patches in the mouth and on the tongue. These patches can get sore and turn into ulcers.Well-controlled blood glucose levels help to avoid thrush. Not smoking and, if you have dentures, taking them out at night also help. See your doctor for treatment if thrush develops.

 

• Visit your dentist at least once every six months to prevent minor problems becoming major ones.
• Professional cleaning helps remove tartar build-up in areas not reached with regular brushing and flossing.
• Remind your dentist you have diabetes at every visit.

There is also some evidence that dental disease is associated with an increased risk of coronary heart disease, particularly in young men.

More here Better Health Channel – “Diabetes and Oral Health”

American Diabetes Association ” Periodontal Disease ” video

Kind Regards,

David, Diabetes Educator