Diabetes and your Oral Health

Lets start with what is Diabetes?

Diabetes is a chronic condition associated with abnormally high levels of sugar or glucose in the blood.  Insulin, which is produced by the pancreas, lowers blood glucose. Absence or insufficient production of insulin or an inability of the body to properly use insulin causes diabetes. There are different types of diabetes. Type 1, Type 2, Gestational as well as prediabetic.  Most Canadians diagnosed with diabetes have type 2 diabetes.

If Diabetes is left untreated or poorly managed, it can affect your oral health in the following ways:

*You will have less saliva causing your mouth to feel dry. Saliva is your bodies way of  protecting your teeth and if you have limited saliva you are much more susceptible to decay.

*Your gums may become inflamed and bleed often. You will be more susceptible to Periodontal disease.

*You are more likely to get oral infections inside your mouth, including sores, ulcers, and yeast infections.

*Altered taste sensation, difficulty tasting food. This includes Burning mouth syndrome.  If you feel severe burning and pain in your mouth , let your dentist know.

*You may experience delayed wound healing, ie.  when there is a cut in your mouth it typically takes longer to heal.

*Diabetic children may have earlier eruption of their teeth than is typical

Let’s review some of these key points in detail:

Diabetes and Gum Disease

There is a higher risk of gum disease also known as periodontal disease if you have Diabetes.  Symptoms of gum disease include, red swollen gums that bleed often during brushing or flossing, gums that pull away from teeth, pus between teeth and gums and tenderness to touch, all this is usually accompanied by a consistent foul odor from the mouth. Patients can manage the risk of periodontal disease by managing blood glucose levels and keeping within an optimal range.  Periodontitis or gum disease can cause your gums and surrounding bone to pull away from your teeth, which in turn can cause loosening of teeth and eventual tooth loss. Periodontitis tends to be more severe amongst Diabetics, as it lowers the ability to resist infection and because of poor wound healing. It is of vital importance that Diabetics come in for their regular dental cleanings and are monitored by the dentist for sudden changes in their periodontal health. If need be referals to Periodontists (gum specialists) may be advised if the oral health worsens. This is to prevent any tooth loss from becoming a reality. Practicing  good oral hygiene and having professional deep cleanings done in the dental office are key. This in fact, can help lower your HbA1c (the lab test that shows your average level of blood sugar over the previous three months).


Dry Mouth or Xerostomia

Xerostomia occurs when your salivary glands don’t produce sufficient saliva to keep your mouth moist. This causes the tissues in your mouth to feel sore and inflamed.  It can make chewing. tasting and swallowing difficult. Dry mouth can further lead to soreness, ulcers, infection and tooth decay. The fungus that thrives on high glucose levels in the saliva of people with diabetes can cause Oral Thrush/candidiasis or yeast infections. Oral thrush can cause white or red patches in the mouth which can lead to discomfort and ulcers. What can be done to combat dry mouth? Drink lots of water, control blood sugar levels, change to a healthier diet and exercising more .  Avoid smoking .  If you wear any type of denture, clean it daily especially after each meal. There are certain rinses and chewing gums that can promote saliva flow that your dentist can advise you to try. Whatever you do, do not suck on candy to combat dry mouth.     


Diabetes and Tooth Decay

Dry mouth and the increase in glucose in the saliva is an ideal environment for bacterial plaque to thrive.  You can remove most of the dental plaque in the mouth when you brush and floss your teeth at least twice a day using a fluoride toothpaste, and floss between your teeth daily.  Additionally using a fluoride mouthwash, avoiding overly sugary and acidic foods and drinks, visiting the dentist and drinking plenty of water.


Always inform your dentist of any medical conditions you may have but especially Diabetes, so that she can monitor your oral health and provide a good course of treatment for you.  Let her know if your diabetes is under control, if you take your insulin, and when your last usual dose was administered. If there are any changes to your medical history or your list of your medications, please let the office know.