Diabetes and Your Oral Health

As of Wednesday Jan. 26, 2011, the Center for Disease Control and Prevention raised their estimate on how many American have diabetes to nearly 26 million, which means approximately 1 in 12 Americans have the disease.  This new figure represents a 9 percent increase from the 2008 estimate of 23.6 million. People with diabetes can have problems with their eyes, nerves, kidneys, heart and other parts of their body, such as the mouth.  Diabetes lowers your resistance to disease and slows the healing process of the body.

 There are numerous oral health problems associated with diabetes, including tooth decay, periodontal (gum) disease, salivary gland dysfunction, fungal infections, taste impairment, lichen planus and lichenoid reaction.

How can diabetes cause tooth decay?  Plaque is a biofilm produced by acid secreting bacteria. The sticky biofilm forms a protective layer for the bacteria.  After a meal the bacteria digest the sugar and secrete acid. This acid weakens the enamel layer of your teeth and can eventually cause cavities. Frequent snacking leads to repeated acid production. If this plaque is not removed it becomes mineralized and hardened forming calculus (tarter). When diabetes is poorly controlled there is high glucose (sugar) levels in the saliva.  Glucose is the food on which cavity causing bacteria lives on and thus this increase allows them to thrive. The increase in bacteria digestion of sugar increases cavity causing acid in the mouth. 

What is the connection between diabetes and periodontal (gum) disease? Diabetes lowers your resistance to infection and slows the healing process of the body. Periodontal disease is an infection of the gums and bone around the teeth.  There is a strong link between periodontal disease and diabetes. Patients with poorly controlled diabetes tend to develop periodontal disease more often and more severely than patients whose diabetes is under control.  Periodontal disease can lead to the loss of teeth and the signs of this disease can be hard to spot sometimes. Good maintenance of both your diabetes and oral health are extremely important to the health of your gums. 

This maintenance includes well controlled sugar levels, healthy diet, good at-home oral care and regular visits to your dentist. During your dental visit your dentist will do periodontal screenings.  Your dentist may recommend more frequent cleanings. If you are concerned about your diabetes affecting your oral health contact your dentist.

Xerostomia (dry mouth) is a common complaint in diabetic patients.  Reduced saliva increases the risk of tooth decay and periodontal disease because saliva acts as a protective factor. If you feel like you are suffering from Xerostomia your dentist my recommend using a fluoride mouthwash or topical fluoride.  These products help prevent increased tooth decay due to decreased saliva.   Chewing sugarless gum or using sugarless mints may help. Frequent water drinking or sucking on ice chips may also help.

Oral candidiasis (thrush) is an oral fungus which occurs more frequently in diabetic denture wearing patients.  This fungal disease can cause red or white patches in the mouth.  Thrush can cause a burning sensation that can be quite painful.  Good oral hygiene such as taking out your denture at night is important.

Diabetes has been associated with the overall health of your mouth. If you have questions about your oral health and diabetes contact your dentist.