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Diabetes & Dental Health

If you live with diabetes, you’re probably aware of some of the associated health problems you need to keep an eye out for, but did you know that it could also affect your oral health?

The increased risk of developing tooth decay and severe periodontal disease means that you cannot afford to ignore the early warning signs of any dental issues. This can be a challenge, particularly if you have a dental phobia. Read on to learn more about diabetes-related oral health problems and what you should do.

Diabetes is a condition that affects your body’s ability to turn food into energy. If you have diabetes, your blood sugar levels may be too high. This can cause tiredness, excessive thirst, a constant need to urinate, and the risk of recurrent infections.

There are two types of diabetes: Type one diabetes causes your immune system to attack the body’s insulin-producing cells. Type two diabetes occurs when the body doesn’t produce enough insulin, or the cells don’t react to insulin.

The most common form is type two diabetes. Both types of diabetes can significantly impact the health of your heart, kidneys, nerves, eyes, and more. 

Diabetes can also have a severe effect on your oral health.

If you live with diabetes, the likelihood of developing oral health issues such as cavities or gum infections increases. This is because the blood supply to your mouth can be reduced as a result of the condition, and there is a potential for an increased amount of sugar in your saliva.

Other common oral health problems associated with diabetes include: 

  • Dry mouth
  • Bad breath
  • Ulcers
  • Oral thrush
  • Gingivitis
  • Periodontitis

Diabetes can slow the body’s natural ability to heal from infection and physical trauma. This means that it can take longer to treat oral health problems, and you may also need to allow more time to recover following dental procedures.

Age is an associated factor. If you’re over 50 years of age and have diabetes, there is a greater chance that you’ll experience dental issues.

With this in mind, it’s essential to have regular dental checkups. However, if anxiety prevents you from getting the help you need, this guide will give you some advice on approaching the issue and managing your dental phobia.

Oral Health Problems Associated With Diabetes

Cavities

Cavities are areas in your teeth that have been permanently damaged, causing a small hole in the enamel. Also referred to as caries, cavities are often caused by a high-sugar diet and an insufficient cleaning routine, leading to a build-up of plaque bacteria in the mouth.

If you have uncontrolled diabetes, your saliva will have high sugar levels. This means your teeth and gums are always exposed to sugar, which harmful bacteria in your mouth love to feed on. As the bacteria consume the sugar, it produces acid that damages your teeth.

Gingivitis and Periodontitis 

Gingivitis refers to an inflammation of the gums, while periodontitis is the more advanced and problematic form of gum infection that could cause a breakdown of the bones that anchor your teeth in place.

When plaque accumulates around your teeth and gums, it hardens and becomes tartar or calculus. The plaque and tartar cause irritation to the gums, which results in them becoming inflamed. At this stage, gum disease is known as gingivitis.

If gingivitis is allowed to progress, the disease will affect the underlying bone that holds your teeth in place. As this bone deteriorates, your teeth will become loose and could fall out or need to be extracted.

Diabetes weakens white blood cells and causes a thickening of blood vessels. As a result, nutrients can’t flow effectively to vital areas of your body, including your mouth. As well as a lack of nutrients flowing in, waste products are not taken away. This leads to infection, which your body will struggle to fight.

If you have diabetes, you may get frequent bouts of gingivitis and more severe periodontal disease.

The signs of gum disease to look out for include:

  • Sore or bleeding gums
  • Gums that appear redder than normal
  • Discharge (pus) coming from the gums
  • Persistent bad breath
  • Loose teeth
  • Gaps may start to appear between your teeth

It is essential to speak to your dentist when you experience the initial symptoms of gingivitis, as if this develops into periodontal disease, it will be irreversible.

Dry Mouth

If your diabetes is not controlled, it can lead to a decrease in saliva flow. In turn, this causes dry mouth.

If you have a dry mouth, you may be more prone to ulcers, sores, infections, and tooth decay.

Oral Tissues Failing to Heal

When you have uncontrolled diabetes, tissues won’t heal quickly following dental treatments because the flow of blood to the area that’s been treated is reduced.

Oral Thrush

Because diabetes leaves you prone to infection, you may need to take antibiotics often. This can lead to the development of fungal infections that affect your tongue and mouth. Because the fungus feeds off the sugar in your saliva, people with diabetes are more likely to develop thrush.

This can cause a burning sensation in your mouth as well as open sores and white and red patches on the tongue and insides of your cheeks.

Burning Mouth Syndrome

Thrush, dry mouth, and certain blood pressure medications can cause burning mouth syndrome. If you have this condition, you’ll feel as though you’ve scalded the inside of your mouth by drinking a very hot drink. Your mouth may also feel numb or tingly, and you may lose your sense of taste.

Minimising Oral Health Problems When You Have Diabetes

Since people with diabetes are more prone to oral health problems, you’ll need to take extra care to follow a good dental hygiene routine. If you experience any changes in your oral health, consult your dentist straight away.

General Oral Health Tips for People With Diabetes

The following measures can help reduce the build-up of plaque and tartar — both major contributors to tooth decay and gum disease: 

  • Brush your teeth after every meal for two minutes each time
  • Use a toothbrush with soft bristles
  • Use a dentist-recommended fluoride toothpaste
  • Rinse your mouth using mouthwash
  • Use dental floss to clean between your teeth
  • Visit your dental hygienist regularly for a professional clean
  • Visit your dentist at least twice a year for a routine checkup
  • If you’re a denture wearer, always remove your dentures daily for cleaning
  • If you’re a smoker, speak with your doctor about how you can quit

Monitoring Your Blood Sugar

A healthy blood sugar level needs to be maintained at all times. You can get to know your glycosylated haemoglobin (HgA1C) level. You should be offered a test that identifies this at least once a year. Ideally, your blood glucose levels according to the HgA1C should be below 7%.

You can check your blood glucose levels at home using a blood glucose meter. To do this, you will need to take a tiny pin-prick of blood and place it on a test strip. Using the meter, you will be able to see your current levels and identify whether it’s within the recommended range.

Your doctor should provide you with advice and support for managing your blood sugar levels, blood pressure, and cholesterol. This may mean changing your diet, getting more exercise, and taking prescribed medication.

Keep Your Dentist Informed About the Status of Your Diabetes

Talk to your dentist about any insulin reactions you’ve had and their frequency. If you’ve already had episodes of low blood sugar previously, you’re more likely to have them again in the future. If you take insulin, let your dentist know when you had your most recent dose.

If you need treatment for periodontitis, you must consult your doctor beforehand. Your doctor or dentist will be able to prescribe you any necessary antibiotics ahead of any procedures. In addition, the times you eat your meals and take your insulin may need to change. In some cases, your current insulin dosage may need to be increased to help fight infection.

Your dentist will need to know about any prescribed medicine you’re currently taking, as well as the dose. If the dentist needs to prescribe you any medication, they will need this information to provide you with medicine that won’t interfere with anything else you’re taking.

Providing your dentist with the name, address, and phone number of your doctor will ensure that the dental practice can keep up to date with the status of your diabetes at all times.

Managing Dental Phobia When You Have Diabetes

As previously mentioned, if you have diabetes, you must follow good oral hygiene practices and visit your dentist regularly. 

We understand that this might be hard for you when you have dental anxiety. However, by visiting a Dental Phobia-Certified dentist, you’ll get the support you need to manage your fears.

A Dental Phobia-Certified dentist will:

  • Listen to your concerns, anxieties, and fears surrounding your treatment
  • Carry out checkups and deliver treatment at your pace
  • Work with you to make your experience as comfortable as possible
  • Provide sedation dentistry where required 

Frequently Asked Questions

Does having diabetes put you at greater risk of developing cavities?

There are two ways of looking at the link between diabetes and cavities. First, if you have uncontrolled diabetes, you will have increased glucose levels in your saliva, contributing to tooth decay and gum disease.

In addition to this, you may also eat smaller meals during the day, which leads to an increase in bacteria and a greater risk of cavities.

On the other hand, if you monitor your sugar levels correctly, it is likely that you’d consume less sugary foods, decreasing the risk of decay or gum disease.

Could I lose my teeth if I have diabetes?

If you have uncontrolled diabetes, you will be at an increased risk of developing gingivitis and periodontal disease. When gum infections are not treated promptly, the bone that holds your teeth in place can be affected. When this occurs, your teeth may fall out. In some cases, extraction may be necessary.

A further complication is that infections are harder to resolve if you have diabetes, so intervention needs to be provided as early as possible.

Providing you’ve got a good oral health regime, are managing your sugar intake properly, and making regular visits to your dentist, the risk of infection will be minimised.

How can I minimise the oral health risks associated with diabetes?

There are three measures you can put in place. Firstly, by managing your sugar intake, you’ll not only reduce the impact your diabetes will have on your general health, but you’ll also have lower sugar content in your saliva. This will mean the bacteria in your mouth will have less to feed on, reducing acid erosion and tooth decay.

Speak with your doctor for recommendations on controlling your blood glucose levels through medication, diet, and exercise. 

You should also maintain a good oral health routine. Thoroughly brushing at least twice daily for two minutes at a time will ensure bacteria are kept at bay. Consider flossing to reduce the presence of bacteria and food debris between your teeth and rinse your mouth using mouthwash.

Finally, a regular visit to your dentist will help you stay ahead of any oral health concerns. Catching problems early will mean you’ll have fewer symptoms, and any treatment will have a better success rate.

How can a Dental Phobia-Certified dentist help?

Having fear or anxiety surrounding going to the dentist, or having dental procedures, is completely natural. Dental phobia affects many people, so you’re not alone. That said, it’s important to learn how to manage your anxieties surrounding dental treatment, particularly if you’re at an increased risk of oral health problems because you have diabetes.

One of the ways we recommend managing your fears is by finding a Dental Phobia-certified dentist. Dental Phobia-certified dentists have a reputation for providing considerate and compassionate dental care. Often this means taking check-ups and procedures at your pace. In some cases, it may mean giving IV sedation to help you relax throughout your visit.

What measures can I take to manage my phobia?

If you’re anxious, talk about it. Let the dental practice know about your dental phobia when you make your appointment. They may be able to recommend the quietest time of the day to come so that you won’t feel rushed or have to deal with a long anxious wait in a busy waiting room. 

The dental practice may also be able to offer you a longer appointment so the dentist can work at a pace you’re comfortable with.

Speak to your dentist about the specific things that cause you distress. By talking through these things, your dentist will better understand how they can help reduce your anxiety.

Take a friend or family member. You don’t have to go to your appointment alone, and support from someone you trust make you feel more comfortable. You may also want to consider wearing noise-cancelling headphones and listening to some music you enjoy.

Finally, think about talking to a doctor or counsellor about your anxieties. Your doctor may be able to prescribe medication to help calm your anxiety levels during your appointment, and a counsellor or therapist may help tackle the root cause of your anxieties.

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