It’s known that diabetics are at a higher risk for infections. But, when diabetics think of the long-term complications associated with diabetes, dental health is an area that usually goes unnoticed - even though they’re susceptible to multiple problems affecting the mouth and gums.
In fact, frequent tooth decay sometimes can be the way patients first discover they have diabetes. If an individual who has regular dental check-ups and few cavities begins having frequent cavities, the dentist usually will send the patient to his or her primary care physician for lab work. Bacteria, viruses and fungi naturally occur in the mouth, but when diabetes isn’t under control, the elevated sugar or glucose levels in saliva may help bacteria grow. The most common problems include tooth decay, periodontal disease, salivary gland dysfunction, fungal infections, infection and delayed healing.
Diabetes, itself, also reduces the body’s resistance to infection, so the gums are at high risk of becoming infected. That’s why periodontal diseases - which are infections of the gum and bone that hold the teeth in place - are more common in diabetics. Young adults who have diabetes have twice the risk of developing gum disease when compared to non-diabetics. Patients who have uncontrolled blood sugar levels develop periodontal disease more severely and lose more teeth than individuals with controlled blood sugar levels.
Another thing to watch for is oral candidiasis, or thrush, which is a fungal infection of the mouth that occurs more often in diabetics - mainly because of diminished saliva and increased glucose levels. Some diabetics experience a dry mouth, which also increases the risk of cavities since there’s less saliva to wash away germs and eliminate acids they create. Patients with dry mouth are encouraged to consume more fluids and try chewing gum or eating candy that’s sugar-free, which helps keep saliva in the mouth.
Because oral health and diabetes go hand-in-hand, a patient should inform his or her dentist of the diabetes diagnosis and follow the six-month schedule for cleanings and routine check-ups. Immediate treatment is needed with symptoms such as gums that bleed easily; red, swollen or tender gums; gums that’ve pulled away from teeth; pus between the teeth and gums; persistent bad breath; separation of permanent teeth; or a change in the fit of a bite and partial dentures.
Too, schedule appointments -- or any dental surgeries -- for a time that the blood sugar level is in normal range and the action of the diabetes medication is low, as elevated blood sugars can delay healing (check with your doctor about in-hospital procedures if immediate dental work is necessary and blood sugar levels are elevated). If you take insulin, a morning visit after a normal breakfast is the best time. Be sure to eat before going, and stick to your typical routine.
Learn more about health complications that come with diabetes at a free Diabetes Services Fair on Monday, Nov. 3 from 6-7:30 p.m. in the Blount Memorial Hospital auditorium where medical experts will exhibit. Giveaways include free glucose meters and coupons for free meters.
Dawn Hollaway is a registered nurse and certified diabetes educator at the Blount Memorial Diabetes Management Center, where she also serves as program coordinator. She also holds a master’s degree in public health.