Type 2 Diabetes and Oral Health
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Type 2 Diabetes and Oral Health

The link between type 2 diabetes and oral health

Highlights

  1. People with diabetes are at higher risk for gingivitis, gum disease, and periodontitis.
  2. Diabetes affects your ability to fight off bacteria that can cause gum infections. Gum disease can also affect the body’s blood sugar control.
  3. If you smoke and have diabetes, you’re at a greater risk for oral health concerns than someone who has diabetes and doesn’t smoke.

Diabetes affects your body’s ability to utilize glucose, or blood sugar, for energy. Diabetes can cause many complications. These include nerve damage, heart disease, stroke, kidney disease, and even blindness. Another common health complication is gum disease and other oral health problems. 

According to the American Diabetes Association, people with diabetes are at higher risk for gingivitis, gum disease, and periodontitis (severe gum infection with bone destruction). Diabetes affects your ability to fight off bacteria that can cause gum infections. Gum disease can also affect the body’s blood sugar control.

Diabetes is associated with increased risk for thrush, a type of fungal infection. Additionally, people with diabetes are likely to have a dry mouth. This has been associated with increased risk for mouth ulcers, soreness, cavities, and dental infections.

What the research says

A 2013 study published in the journal BMC Oral Health looked at 125 people with type 2 diabetes. Researchers measured factors including missing teeth, the incidence of periodontal disease, and the amount of reported dental bleeding.

The study found that a combination of the longer people had diabetes, the higher their fasting blood glucose, and the higher their hemoglobin A1C (a measurement of a person’s average blood sugar over three months), the more likely they were to have periodontal disease and dental bleeding.

Those who did not report careful self-management of their condition were more likely to have missing teeth than those who did work to control their blood sugar levels.

Risk factors

Risk Factors

Some people with diabetes are at greater risk for oral health problems than others. For example, people who don’t maintain tight control over their blood sugar levels are more likely to get gum disease. 

Also, if you smoke and have diabetes, you’re at a greater risk for oral health concerns than someone who has diabetes and doesn’t smoke.

According to the National Institutes of Health, more than 400 medications have been linked to dry mouth. These include medications commonly used to treat diabetic nerve pain, or neuropathy. You can ask your doctor or pharmacist if your medications may increase your risk for dry mouth. If needed, a dentist can prescribe oral rinses that can reduce dry mouth symptoms. Sugar-free lozenges to ease dry mouth are available without a prescription at most pharmacies.

Warning signs

Warning

Gum disease related to diabetes does not always cause symptoms. For this reason, it’s important to make and keep regular dentist appointments. However, there are some symptoms that could indicate that you’re experiencing gum disease. They include:

  • bleeding gums, particularly when you brush or floss
  • changes in the way your teeth seem to fit together (or “malocclusion”)
  • chronic bad breath, even after brushing
  • gums that appear to pull away from the teeth, which may cause your teeth to look longer or larger in appearance
  • permanent teeth that begin to feel loose
  • red or swollen gums

Prevention

Prevention

The best way that you can prevent diabetes-related complications in your dental health is to maintain optimal control over your blood sugar levels. Check your blood sugar regularly and notify your doctor if you cannot control your levels with diet, oral medications, or insulin. 

You should also take excellent care of your teeth through regular brushing, flossing, and dentist’s visits. You may need to ask your dentist if you need to make more regular visits than the twice yearly recommendation. If you do notice any warning signs for gum disease, seek immediate dental treatment.

Check your mouth for abnormalities on a monthly basis. This includes looking for areas of dryness or white patches in your mouth. Bleeding areas are also cause for concern.

If you have a dental procedure scheduled without your blood sugar being under control, you may need to postpone the procedure if it isn’t an emergency. This is because your risk for post-procedure infection is increased if your blood sugar levels are too high.

Treatment

Treatment

Treatments for oral health conditions related to diabetes depend on the condition and its severity. 

For example, periodontal disease can be treated with a procedure called scaling and root planning. This is a deep cleaning method that removes tartar from above and below the gum line. Your dentist may also prescribe antibiotic treatments. 

More rarely, people with advanced periodontal disease need gum surgery. This can prevent tooth loss.

Outlook

Outlook

With careful attention to your diabetes control and dental health, you can maintain healthy teeth and gums. Visit your dentist regularly and disclose your diabetes, symptoms you may be experiencing, and medications you’re taking. This information can help your dentist provide the best treatments.

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