Problems with teeth and gums can be more common for people with diabetes, so good dental health is important to prevent dental complications developing. Looking after your teeth and gums is an essential part of learning to live with both type 1 diabetes and type 2 diabetes
You should inform your dentist if you have either new-onset or long-standing diabetes as this might affect your dental treatment and how often they must review your teeth and gums.
Diabetes and dental hygiene
People with diabetes who have poor control of their blood glucose levels are more likely to develop dental health problems. Therefore keeping your blood sugar within a normal range will reduce this risk. Eating a balanced diet, getting regular exercise and giving up smoking is also advised to lessen the risk of oral health problems.
Making sure that you visit a dentist every six months ensures that any infection will be treated as early as possible. Minor dental problems can quickly escalate, and a routine visit to the dentist will pick up on these.
In the UK, although people with diabetes are more prone to dental problems, they do not receive any extra financial help for dental treatment.
What are the symptoms of dental health problems?
- Sore or swollen gums
- Bleeding gums
- Receding gums
- Loose teeth
- Bad breath
You should visit your dentist if you experience any of these symptoms; urgent treatment might be required to prevent a problem from worsening.
Diabetes and gum diseases
Having prolonged high blood glucose levels can increase the risk of oral health problems, such as gum disease.
Gum disease, also known as periodontitis, is the sixth most common disease in the world. It occurs when bacteria within the mouth begins to form into a sticky plaque which sits on the surface of the tooth.
Gum disease is classified on the severity of its development. There are three stages of gum disease:
- Gingivitis : Gingivitis is the initial stage of gum disease, caused by poor oral hygiene and irregular plaque removal from teeth. It is characterised by swollen, red and tender gums and it can cause bleeding when brushing. Luckily gingivitis is reversible, and through improving your oral hygiene techniques and visiting your dentist or hygienist for advice on a home dental health care program, you should be able to reverse this process.
- Periodontitis (Mild): Untreated gingivitis can lead to mild periodontitis. The conversion of gingivitis to periodontics is more common in people who have a family history of gum disease, poor oral hygiene and uncontrolled diabetes. At this stage there will be damage to the gums and bone supporting the teeth. In order to prevent further damage a prompt visit to the dentist is required to prevent further progression.
- Periodontitis (Severe): This is the most advanced stage of gum disease, characterised by significant tissue and bone loss around the teeth
Having prolonged high blood glucose levels can lead to gum disease developing or worsening more quickly, but keeping your levels within a normal range reduces the risk of infection spreading.
Unfortunately, when your body begins to fight an infection, blood glucose levels will usually rise in response. Should the infection in your mouth become worse, you could have problems with food intake, which might affect your diabetes management.
Your dentist can help you with your diabetes if you have developed gum disease or another mouth infection.
Thrush is a fungal infection which can occur in the mouth; sometimes secondary to dry mouth, following a course of broad-spectrum antibiotics. People with poor blood sugar control are more likely to develop thrush.
Signs of oral thrush include white patches within the mouth, redness of the tongue and cracking of the skin at the corner of the lips.
Dental treatment and blood sugar levels
If you are on medication that can lead to hypos, such as insulin or sulphonylureas, speak with your dentist or your doctor to see if your medication will need to be modified before the dental work.
Your appointments for dental treatment should be arranged to fit in with your diabetes treatment regime.
High blood sugar levels may affect the time the gums take to heal. For example, if you have a tooth removed, and it is taking an unusually long time to heal, you should immediately contact your diabetes healthcare team or dentist for advice.
Dental hygiene, diabetes, and heart problems
Diabetes can lead to excess cholesterol building up in the bloodstream, raising the risk of heart disease.
A number of studies have shown that people with gum disease may have a higher risk of heart disease. Bacteria and inflammation in the gums may escape into the blood system and cause blockages in the blood vessels, which reduce blood flow to the heart.
More research is being carried out to further investigate the effect of gum disease on the heart.
Dental hygiene tips and facts
These 10 tips and facts will help you to maintain good dental health:
- Brush your teeth last thing at night and at one other time in the day; the most important brush is the one at the end of the day
- You should use small brushes or floss once a day to remove the plaque from in-between your teeth, preferably before toothbrushing.
- Fluoride in toothpaste keeps the teeth strong and prevents dental decay
- To prevent dental decay you should reduce the frequency of sugary snacks and carbonated drinks
- After brushing spit out don’t rinse the excess toothpaste away – this will keep fluoride on your teeth
- The mechanics of brushing your teeth makes it better at removing dental plaque and maintaining healthy gums than using mouthwash
- Water is the only drink that you should take to bed at night
- A timer can be useful to make sure you brush for a full 2 minutes
- If you are diagnosed with gum (periodontal) disease, your blood sugar control may be more difficult to manage, but effective gum treatment can help to improve it
- Your teeth and gums should be checked by a dentist at least once a year; the dentist will advise how often you should attend the dentist or hygienist for treatment
Visiting the dentist
Many of us become a little anxious before a dentist appointment but don’t be tempted to put off a dentist visit. If some treatment is needed, it will be less serious than if the treatment is put off.
Make sure your dentist knows you have diabetes as they may need to take this into account when they give advice or recommend treatment.