Oral care for diabetes
What is diabetes?
Diabetes Australia estimates that 1.7 million Aussies are diabetic – but about a third them don’t know it! Diabetes is a disease that results in too much glucose in the blood because of a problem with insulin, the hormone needed for glucose to enter the cells and convert to energy. Either the body doesn’t produce enough insulin, or it becomes resistant to the insulin it has and cannot use it properly. Diabetes is Australia’s 6th biggest killer, leading to heart attacks, strokes, kidney failure, amputations and blindness.
Types of diabetes
Type 1 diabetes accounts for 10–15% of diagnoses, mostly affecting young people. Type 1 diabetes occurs when the pancreas stops producing insulin, and the onset is sudden. Diabetics of this kind need to inject insulin daily to allow the glucose to be used by their body’s cells.
Type 2 diabetes is one of the fastest growing chronic diseases in Australia. Formerly called adult onset or non-insulin dependent diabetes, it develops slowly and is related to lifestyle, diet and genes. In those suffering Type 2 diabetes, the body’s cells become resistant to insulin, causing increased insulin production by the pancreas. The pancreas eventually wears out, dropping insulin production, and advanced Type 2 diabetics suffer from both insulin-resistence and insufficient insulin production.
Effects on diabetes on your teeth and mouth
Diabetes has a huge impact on your oral environment. In fact, dentists can pick up symptoms in your mouth that might indicate you have diabetes before you are aware of it. High blood glucose affects saliva production and consistency, your healing ability and your susceptibility to infections, all of which can be reflected in changes in your oral health.
The importance of saliva
A loss of fluid from the body and changes in the blood supply to salivary glands causes a decrease in the amount of saliva present in the mouth. This can be devastating to the mouth as saliva is a fabulous (or should be) substance which performs many important functions. Saliva contains nutrients for the teeth and gums and anti-bacterial matter, both of which help prevent cavities and gum disease. Saliva lubricates and protects our oral environment.
Oral symptoms of diabetes
The following symptoms can all indicate a systemic change in your body cause by diabetes.
- increased swelling and bleeding in gums
- changed saliva
- increased decay
- infections such as oral thrush
- poorly healed ulcers.
Oral complications of diabetes
The symptoms of diabetes that are visible in the mouth can lead to many complications, including the following:
- poor healing
- xerostomia (dry mouth)
- candidiasis (oral thrush)
- increased risk of caries (holes in teeth)
- gingivitis – gum disease
- periodontal disease – gum and bone disease
- abscesses – infection in the bone due to the tooth infection
- burning mouth syndrome (chronic sensation of burning with no identifiable cause).
Poor diabetes management and the presence of calculus (the mixture of food, saliva and bacteria that sets hard like plaster and sticks to your teeth) increases the severity of periodontal disease. Diabetic patients have more severe cases of gum disease than people who are not diabetic. Periodontal disease was also found to occur at a younger age in diabetic patients.
Managing diabetes involves your dentist
Because of the devastating effects of diabetes on your mouth and teeth, your dentist needs to be involved in the lifelong management of diabetes. Your physician will develop an individual program to manage your blood sugar levels, with enough flexibility to cope with any changes in the progress of the disease. Alongside this, regular dental visits are essential for treating oral problems early, and avoiding the complications of diabetes on the mouth and teeth.
A typical plan for diabetes management involves the following goals:
- Continually work with your medical practitioner to maintain normal blood glucose levels.
- Maintain healthy body weight.
- Work with your dentist and hygienist to remove all calculus and plaque on a regular basis. Brush properly and floss daily.
- Have regular examinations by your dentist every 6 months so that problems can be detected early.
Prevent serious oral damage
The earlier the preventative program is put into action, the more successful it will be. The most important element of this program is regular dental visits so that problems can be spotted and treated early, and to remove the calculus that cannot be cleaned by brushing alone.