Dental care and diabetes: Guide to a healthy mouth

When you have diabetes, elevated blood sugar levels can damage many parts of your body, including your mouth and teeth. Diabetes increases your risk of gum disease, cavities and tooth loss, dry mouth, and a variety of oral infections.

Conversely, poor oral health can make your diabetes more difficult to control. Infections may cause your blood sugar to rise and require more insulin to keep it under control.

In addition, diabetes can diminish your ability to taste sweets. Although this change may not be noticeable, it can influence your food choices in favor of additional sweeter tasting foods, thereby affecting your dental health, as well as your ability to control your diabetes.

Awareness of potential oral complications from diabetes will improve your chances of maintaining a healthy mouth and sound teeth.

Tooth and gum damage: Diabetes can take a toll

Day in and day out, high blood sugar caused by diabetes can contribute to progressive damage to your teeth and gums, which may cause tooth loss. Here’s how it happens.

Plaque: Diabetes feeds this cavity-causing menace. An invisible film of bacteria, saliva and food particles (dental plaque) normally covers teeth. The bacteria feed on the sugars and starches in the foods and beverages you consume and produce acids that damage the hard enamel coating of your teeth.

Higher blood sugar that accompanies diabetes gives the bacteria a greater supply of sugars and starches, leading to production of even more acid. Damage from this acid increases the risk of tooth decay (cavities).

Gum disease: From irritation to tooth loss

Dental plaque can also cause other problems. If you don’t remove it from your teeth with regular brushing and flossing, it hardens under your gumline into a substance called tartar, or calculus.

Tartar irritates the gums and causes gingivitis. This makes the gums tender, swollen and red, and they may bleed when you brush your teeth. Fortunately, your dentist or dental hygienist can prevent or treat gingivitis by removing tartar during a professional dental cleaning.

Untreated gingivitis leads to a more serious condition when bacteria infect your gums and the bones around your teeth (periodontitis). This can cause your gums to pull away from your teeth and your teeth to loosen and even fall out.

Gingivitis and periodontitis are the most common oral complications of diabetes. If you have type 2 diabetes, you’re three times as likely to develop such gum disease as is someone who doesn’t have diabetes. Diabetes lowers your body’s resistance to many infections and slows the rate at which you heal.

In addition, some research suggests that people with gum infections may be at increased risk of cardiovascular disease. One theory is that bacteria from the mouth enter the bloodstream and cause inflammation throughout the body, including the arteries. This may be linked with the development of atherosclerotic plaques in the arteries, which increases the risk of heart attack and stroke.

To help prevent damage to your teeth and gums:

• See your dentist at least twice a year, and make sure your dentist knows that you have diabetes.

• Brush your teeth twice a day, using a soft nylon toothbrush, and brush the upper surface of your tongue.

• Floss every day.

• Look for early signs of gum disease, such as bleeding gums, redness and swelling. If you notice them, see your dentist.

www.mayoclinic.com

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