Diabetes and Dental Health:

Prevention may prevent problems especially if you have diabetes, the disease that harms your mouth, eyes, nerves, kidneys, heart, and other important systems in the body. Dental Patients who have diabetes should inform their dentist about the condition thereby assisting the dentist in providing the appropriate care. This information may play a vital role for you in maintaining your teeth and your gums in conjunction with your dentist. All medications you may be taking should be addressed to your dentist to maintain optimal oral health.

Common Problems Associated With Diabetes Are:

1. Salivary Gland Dysfunction which leads potential to dry mouth and increased risk for cavities (Tooth Decay).
    
2. Risk for infection due to poor blood supply (Periodontal Disease).
    
3. Tooth Loss due to gum infection leading to bone loss.
    
4. Slower healing after dental surgery (Extractions, Gum Surgery, Implants).
    
5. Burning Mouth Syndrome, and taste impairment.
    
6. Yeast infection (Oral Candidasis) and Mouth Ulcers (Lichen Planus).

Poor Glucose control, you can expect poor teeth and gums. Poor sugar control leads to a greater chance of getting periodontitis, and the odds are that it will be worse if you are diabetic. Therefore periodontitis is increasingly harder to treat and you may lose your teeth. Diabetics treatment, with well-controlled blood sugar have the same chance of periodontal disease than people without diabetes, including those with Type 1 Diabetis.
Periodontitis (chronic infection of any area around the tooth) this inflammation is often hidden from view. In the advanced stage it is a significant problem and causes painful chewing, bone loss, and loosened and weak teeth, allowing the teeth to increased decay and require removal.

Why?

1. Changes of the blood vessels - When diabetic blood vessels thicken, the flow of oxygen and nutrients to the gums is reduced. This reduced flow slows the clearing of waste products. This combination weakens the resistance of gum tissue and bone structure and may lead to an infection.

2. The lack of good regular oral hygiene, meaning home care as well as professional dental care. If sugary food particles are left on the teeth this will assist the bacteria in breaking the particles down to plaque which will eventually harden to calculus if not cleaned off. This contributes to gum irritation, resulting in bone loss and decay. Most diabetic patients may require more regular cleanings in order to help maintain ideal oral health.
    
3. Poor diet will increase the risk of diabetes and your overall well being.
    
4. Smoking - The  facts about smoking and gum disease are:
   Smokers are five times more likely than nonsmokers to have gum disease. Diabetic smokers, age 45 or older, are 20 times more likely to get severe gum disease.

What the Diabetic Patient Can Do?

1. Consistent screenings on a regular base for diabetes and tacking the medications as prescribed by your physician.
    
2. Knowing your personal degree of diabetic control and communicate this with your dentist each visit.
    
3. If periodontal treatment is needed, question your diabetes doctor to communicate to the dentist or periodontist about your overall medical condition and the medication you take.
    
4. Acute infections in your mouth, such as an abscess, are considered an emergency and should be treated right away, regardless of glucose control difficulties.
    
5. With the successful treatment of the periodontal infection, it is often easier to control blood sugar.
    
6. Good oral home care – including regular flossing and proper brushing (at least 2 minutes) will keep the bacteria count low and remove the sugars from your mouth.
    
7. To avoid a dry mouth drink plenty of water. Chewing a sugar-free gum may help to stimulate the saliva flow.
    
8. Make sure that your denture or partial denture fits well to avoid irritation which can promote infection.
    
9. Be sure you have a healthy meal in the morning before your dental appointment, take any required insulin and discuss your condition with your dentist in advance.
    
10. Good nutrition and diet. This may include Vitamin C, which has been shown to improve collagen formation and promote healing especially if gum surgery is indicated.
     
11. It is recommended that patients with diabetes should schedule appointments first thing in the morning to allow time for anesthetic to wear off and to avoid disrupting your mealtimes.
     
12. Options such as saliva substitutes and fluoride rinses may be discussed with your dentist to see if that would be appropriate for you.
     

Taking care of your Dental Health:

Plaque Removal: Periodontitis has affected your mouth regardless the stage your mouth is in, if you want to keep your own teeth, the plaque must be removed. In the early stage of plaque, your dental hygienist, dentist or periodontist will use the measure of deep cleaning to remove hardened plaque and infected tissue under the gum and may smooth the damaged root surfaces of your teeth. This cleaning and smoothing will allow the gum to re-attach to the teeth. Sometimes, your dentist may tell you to use a special mouthwash or take an antibiotic to help control the infection. Brush and floss regularly to keep plaque from returning

Periodontal Surgery: In the advanced stage of periodontitis to the point of destroying too much tissue, the periodontist will cleans out the infected pocket, and reshapes or replaces the damaged tissues supported by the teeth.

Other Oral problems Linked to Diabetes:

Thrush - (Oral Candidiasis), is a fungus infection caused by the overgrowth of Candida albicans, a yeast-fungus that thrives on high glucose levels in saliva. The main reason for the overgrowth or contribute are smoking and wearing dentures (especially all the time). The daily habit should be tight glucose control, not smoking, and if you wear dentures, daily removal and cleaning . This procedures may help to prevent thrush.

Dry Mouth: Soreness, ulcers, infections and tooth decay are more common occurrences because of having little or no saliva to lubricate the mouth and help remove bacteria and food buildup that causes plaque and tooth decay. Saliva is the automatic cleaner within the oral cavity.
Dry mouth is may be a side effect of medication. There are more than 400 over-the-counter and prescription drugs that cause dryness of the mouth. These medications include cold medicine, high blood pressure and depression medications. Let your health practitioner or dentist know if you feel your mouth is too dry. A different drug or the use of "artificial saliva" will help keep your mouth moist and protect your teeth.

Tips to Protect your Teeth and Gums:

Brushing: The single most successful way to keep your natural teeth is the habit to brush your teeth twice a day and the use of dental floss either before or after you brush.

Home Control: Plaque (the build up along the base of the teeth around your gums) is hard to see unless it is old and stained or it can be seen with the help of a red "disclosing tablet" They are available at grocery or drug stores. 
Anyone, especially people with diabetes, should have their teeth checked at least every six months.

• If you have any problem with your teeth, gums, jaw or mouth, don't wait for your next appointment. Make sure to see your dentist immediately.

• It is well advised to remind your dentist at each visit that you have diabetes.
   
• If you change your dentist, again, it is well advised to make sure your new dentist knows that you have diabetes.
   
• Frequent dental check-ups will detect problems early on, when treatment is most effective.