Dr. Amit Agrawal

Did you know that 29.1 million people living in the united states have diabetes? that's 9.3% of the population. Approximately 1.7 million new cases are diagnosed each year and 8.1 million people living with diabetes don't even know they have it. 

Diabetes affects your body's ability to process sugar. All food you eat is turned to sugar and used for energy. In type I diabetes, the body doesn't make enough insulin, a hormone that carries sugar from your blood to the cells that need it for energy. In type ii diabetes, the body stops responding to insulin. Both cases result in high blood sugar levels, which can cause problems with your eyes, nerves, kidneys, heart and other parts of your body.

So what does this have to do with that smile of yours and how can you protect it? first, it's important to understand the signs of diabetes and the roles they play in your mouth.

The symptoms of untreated diabetes

The warning signs of diabetes affect every part of your body. After a blood test, you may be told by a doctor that you have high blood sugar. You may feel excessively thirsty or have to urinate a lot. Weight loss and fatigue are other common symptoms. Diabetes can also cause you to lose consciousness if your blood sugar falls too low. 

If diabetes is left untreated, it can take a toll on your mouth as well. Here's how:

You may have less saliva, causing your mouth to feel dry. (dry mouth is also caused by certain medications.)
Because saliva protects your teeth, you're also at a higher risk of cavities.
Gums may become inflamed and bleed often (gingivitis).
You may have problems tasting food.
You may experience delayed wound healing.
You may be susceptible to infections inside of your mouth.
For children with diabetes, teeth may erupt at an age earlier than is typical.
Why people with diabetes are more prone to gum disease

All people have more tiny bacteria living in their mouth now than there are people on this planet. If they make their home in your gums, you can end up with periodontal disease. This chronic, inflammatory disease can destroy your gums, all the tissues holding your teeth and even your bones.

Periodontal disease is the most common dental disease affecting those living with diabetes, affecting nearly 22% of those diagnosed. Especially with increasing age, poor blood sugar control increases the risk for gum problems. In fact, people with diabetes are at a higher risk for gum problems because of poor blood sugar control. As with all infections, serious gum disease may cause blood sugar to rise. This makes diabetes harder to control because you are more susceptible to infections and are less able to fight the bacteria invading the gums.

How your dentist can help you fight diabetes

Regular dental visits are important. Research suggests that treating gum disease can help improve blood sugar control in patients living with diabetes, decreasing the progression of the disease. Practicing good oral hygiene and having professional deep cleanings done by your dentist can help to lower your hba1c. (this is a lab test that shows your average level of blood sugar over the previous three months. It indicates how well you are controlling your diabetes.)

Your diabetes dental health action plan

Teamwork involving self-care and professional care from your dentist will be beneficial in keeping your healthy smile as well as potentially slowing progression of diabetes. Here are five oral health-related things you can do to for optimal wellness:

Control your blood sugar levels. Use your diabetes-related medications as directed, changing to a healthier diet and even exercising more can help. Good blood sugar control will also help your body fight any bacterial or fungal infections in your mouth and help relieve dry mouth caused by diabetes.
Avoid smoking.
If you wear any type of denture, clean it each day.
Make sure to brush twice a day with a soft brush and floss correctly daily.
See your dentist for regular checkup.

If your diabetes is not under control, you are more likely to develop problems in your mouth. The good news is you can keep your teeth and gums healthy. By controlling your blood glucose, brushing and flossing every day, and visiting a dentist regularly, you can help prevent serious problems in your mouth.

The Symptoms of Untreated Diabetes

The warning signs of diabetes affect every part of your body. After a blood test, you may be told by a doctor that you have high blood sugar. You may feel excessively thirsty or have to urinate a lot. Weight loss and fatigue are other common symptoms. Diabetes can also cause you to lose consciousness if your blood sugar falls too low. 

If diabetes is left untreated, it can take a toll on your mouth as well. Here's how:

1. You may have less saliva, causing your mouth to feel dry. (Dry mouth is also caused by certain medications.)
2. Because saliva protects your teeth, you’re also at a higher risk of cavities.
3. Gums may become inflamed and bleed often (gingivitis).
4. You may have problems tasting food.
5. You may experience delayed wound healing.
6. You may be susceptible to infections inside of your mouth.
7. For children with diabetes, teeth may erupt at an age earlier than is typical.

Diabetes is a chronic, systemic disease and affects all parts of the body. While its effect on the nerves, eyes, kidneys, and skin is more common, their oral effects are less known. However, diabetes will vouch how they lost tooth and have dry mouth after their sugars went out of control.

1. Oral Symptoms in Diabetics: There is a strong correlation between oral health and poorly controlled blood sugars. Some of the common oral indications of diabetes are as follows.
2. Dry Mouth: There is less amount of saliva, which brings with it a whole lot of symptoms including soreness of the mucosa, ulcers, increased chances of infection, gum inflammation and tooth decay.
3. Thrush: The saliva has higher sugar levels and attracts fungus (Candida in particular) which thrives in this dry, sugary environment. This produces a burning sensation in the mouth.
4. Periodontal Disease: The gums get severely infected with gingival recession, where the gum line recedes exposing more of the tooth (tooth length seems to have increased). There is “pocket” formation, or space between the tooth and the gum which hosts a variety of bacteria. The periodontal ligament loses its strength to hold the tooth in place, and thereby teeth become mobile. If not worked upon in time, there could be multiple teeth lost.

Why People with Diabetes Are More Prone to Gum Disease

All people have more tiny bacteria living in their mouth now than there are people on this planet. If they make their home in your gums, you can end up with periodontal disease. This chronic, inflammatory disease can destroy your gums, all the tissues holding your teeth and even your bones.

Periodontal disease is the most common dental disease affecting those living with diabetes, affecting nearly 22% of those diagnosed. Especially with increasing age, poor blood sugar control increases the risk for gum problems. In fact, people with diabetes are at a higher risk for gum problems because of poor blood sugar control. As with all infections, serious gum disease may cause blood sugar to rise. This makes diabetes harder to control because you are more susceptible to infections and are less able to fight the bacteria invading the gums.

As much as it sounds alarming, it is not. There are easy, simple ways to manage these. In fact, good overall management of diabetes will ensure the oral symptoms are also maintained under control. Following are some things to do which will help in managing diabetes in general and the oral symptoms in particular:

As soon as diabetes is diagnosed, visit a dentist to take stock of the oral health condition. Any identified problem should be treated to avoid progression.

1. Keep a close watch to ensure blood sugar remains as close to normal as possible.
2. Switch to a toothbrush with soft or extra-soft bristles. This will help reduce the pressure on the gums and thereby prevent gum bleeding
3. After every meal, remember to brush the teeth.
4. Flossing at least once a day will help remove food deposits between the teeth. Alternately, use interdental brushes.
5. Rinse at least twice daily using an antiseptic mouthwash.
6. Denture-wearers should always clean them daily and never go to sleep with the denture in the mouth.
7. Smoking with diabetics is a strict no-no, work on quitting at the earliest.
8. Visit a dentist every 3 months to ensure oral issues are identified at the earliest and treatment done with minimal intervention.
9. Any dental procedure should be done only when sugar levels are under control.

Managing diabetes is a lifelong commitment, and that includes proper dental care. Your efforts will be rewarded with a lifetime of healthy teeth and gums. If you wish to discuss about any specific problem, you can consult a Dentist.