Type 1 and Dental Issues

[Juicyj]

Hi all,

Last week a routine check up resulted in a tooth extraction... Since diagnosis i've lost 2 teeth that were root filled due to root infections, and I also have gum disease which my hygienist is now helping me sort out, but this has only come about since being diagnosed. I am acutely aware of maintaining good dental hygiene with having type 1, as infections can cause high BG readings, and so follow a virtually sugar free diet, do low carb, keep a good HbA1c etc - but still annoyed i've lost a second tooth. Has anyone else had dental issues and any advice apart from regular brushing, flossing !!)

(This was all in a week of also finding out I have background retinopathy - so have written off last week as bad luck..)

 

[clucker34]

Hi, I've been type 1 for 34yrs ( I'm 36 in nov ) I'm missing 12 teeth all but one due to gum disease which has happened since having my son in 2011 ( the other one I knocked out myself whilst having a bad hypo! ) my dentist/hygienist has said that unfortunately it's another complication that we have to try and manage before it gets put of hand, not much comfort when your got no front teeth lol x x


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[Juicyj]

Thanks for the reply - sorry to hear about your losses, what a pain !

I'm thinking false teeth now - less expensive in the long term !!

No one warned me about this when I got diagnosed, I just was told i'd have to take care of my teeth which I thought I was doing until the hygienist told me otherwise !

 

[noblehead]

When my diabetes wasn't very well controlled I had receding gums, my dentist said this is often seen in diabetics when bg is uncontrolled. I've since improved things but the gums haven't improved but the good news is they stopped receding, the only advice I can give Juicy is to use a good mouthwash such as Listerine and remember to floss between the teeth.

 

[donnellysdogs]

My dentist recommended cordysol for toothpaste and mouthwash and my gums had receded horrible. This last visit since following his advice without the dentist knowing my gums actually got marked up in his numbers.
He too says its diabetes related, but did not put it down to poor control. Just being diabetic.


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[Juicyj]

Hi Donnellys - have you had gum problems since using Cordysol ? I try to use either Listerine or Colgate but without alcohol, i'm not sure if these do help much, i've also been given little brushes to clean between my teeth which are great for brushing off plaque, also learned how to brush my teeth properly so hoping the combination will keep the teeth fixed firmly in my mouth for many years. I did some research and found this article:

Whether you have type 1 diabetes or type 2 diabetes, managing your blood sugar level is key. The higher your blood sugar level, the higher your risk of:

• Tooth decay (cavities). Your mouth naturally contains many types of bacteria. When starches and sugars in food and beverages interact with these bacteria, a sticky film known as plaque forms on your teeth. The acids in plaque attack the hard, outer surface of your teeth (enamel). This can lead to cavities. The higher your blood sugar level, the greater the supply of sugars and starches — and the more acid wearing away at your teeth.
• Early gum disease (gingivitis). Diabetes reduces your ability to fight bacteria. If you don't remove plaque with regular brushing and flossing, it'll harden under your gumline into a substance called tartar (calculus). The longer plaque and tartar remain on your teeth, the more they irritate the gingiva — the part of your gum around the base of your teeth. In time, your gums become swollen and bleed easily. This is gingivitis.
• Advanced gum disease (periodontitis). Left untreated, gingivitis can lead to a more serious infection called periodontitis, which destroys the soft tissue and bone that support your teeth. Eventually, periodontitis causes your gums to pull away from your teeth and your teeth to loosen and even fall out. Periodontitis tends to be more severe among people who have diabetes because diabetes lowers the ability to resist infection and slows healing. An infection such as periodontitis may also cause your blood sugar level to rise, which makes your diabetes more difficult to control. Preventing and treating periodontitis can help improve blood sugar control.

 

[Lucie75]

My dentist has prescribed some high fluoride toothpaste as apparently diabetics need the extra protection that regular toothpaste cannot provide. Perhaps all diabetics should ask about it?

 

[RosieDred]

I get swollen gums and am in the process of getting 10 fillings done. I always had bad teeth before the diabetes but about 3 months before I was diagnosed it escalated and I developed bleeding and swollen gums. My gp told me that mouthwash is useless and to swill my mouth with actimel or anther probiotic drink. I did and it helped a bit but once diagnosed I stopped as I assume it's got sugar in it.

I saw a hygienist last week and she cleaned under my gums with a machine. She had to stop half way though because she couldn't see through all the blood and I've got an appointment for her to finish it in a months. She said that with diabetes there is only so much we can control when it comes to dental care and even if we do the best that we can, we are still at higher risk of having these problems.


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[hale710]

This is a real fear of mine. I'm 24 and never had a filling, I am meticulous about keeping my mouth and teeth clean.

I was diagnosed in February last year. I expressed a concern to my dentist at my appointment in November last year and he said provided I keep good control there should be no reason my dental hygiene would result in fillings and/or gum disease etc. he has moved me from a once a year check up to a 6 monthly check up, which to me indicates he expects to see more change than he's letting on!

Even a well controlled T1 has higher BG than a "normal" person


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[Juicyj]

Well the long term prognosis certainly looks bleak then !!

On a different subject has anyone had dental implants ? I've looked into this as they could support a bridge if I do lose any more teeth, but again would require brilliant BG control to minimize the risk of infections.

Would love to hear about anyone with this to find out how they managed ?

 

[Alanp35]

Mouth infections can also aggravate cardiac any cardiac sensitivities that may exist. I have to have 3G of antibiotics 1 hour prior to dental treatment.




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[Juicyj]

Mouth infections can also aggravate cardiac any cardiac sensitivities that may exist. I have to have 3G of antibiotics 1 hour prior to dental treatment.




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Hi Alan - can you explain further on this ? I've not heard the 2 are connected before so would be interested to know more. Thanks.

 

[Alanp35]

Just that my hygienist and GP have told me that this is the case. If there is a problem with any organ in the body then that organ is not as robust as it may be. An infection from the mouth could get into the blood and cause pericarditis. Been there and not too pleasant, but none of the problems with diabetes are pleasant. Can I suggest that you ask your GP?



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[niknak15]

I'm a dental nurse, the most common reason for decay is eating in between meals. Teeth can withstand 3 sugar attacks a day, this includes fruit and acidic items, so if your snack between meals is acidic or has some sort of sugar in it, including drinks, your risk of decay is higher, if you suffer with hypos during the night this is most harmful as our saliva stops during the night and has remineralising agents in it.

If your flossing everyday, brushing twice a day, and avoiding sugary snacks, which we all know isn't always easy, use a toothpaste with at least 1450ppm sodium fluoride in it ( stated in ingredients).

I'm type 1 and luckily never had a problem with my teeth or gums but I have done this job for 10 years and been diabetic for 17 ( I'm 27) and I have only just in the last 3 years got my hba1c into single figures so if you get a good oral hygiene routine going, you should should see improvements.


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[victry77]

Hi Juicy, I recently posted about dental issue in another thread. Below is my post which I have copied over as it may be relevant to other people with dental issues

****Does anyone ever suffer with intermittent soreness on random areas of their gums?

Just to point out, this started to happen shortly prior to being diagnosed as Type 1 (6yrs ago). Also, my BG is well controlled.

Every so often, I will get a sore area on my gum which I only notice when brushing. Usually the soreness is always just above an upper tooth (normally the canines and sometimes a tooth a bit further back) and when I brush I will develop what looks like a small paper cut on the gum directly above the tooth. This will last for a few days to a week then go. However, it will then reappear after a few weeks/couple of months in an area of gum above another tooth.

The past couple of weeks, I've had it above a back tooth and for the past few days have treated with a course of Corsydol (which has usually been effective in the past). The soreness cleared up after a day, but I just brushed my teeth and noticed soreness above my right canine and sure enough there was the little 'paper cut'.

My last dentist appt. was this time a year ago. Had a couple of filings fixed and told dentist of my occasional random gum soreness. Was told my gums were in pretty good condition apart from a bit of "squelchy gummidge". Went for a hygienist appt. 8 months ago and there was no issues raised about my gum health then either.****

TBH, I never really looked after my teeth brilliantly well as a child/teen and have had a couple of extractions and the back and all of my back teeth are also filled. I've had none pulled from the front but it's here where I tend to experience the random soreness.

I'm currently still using the Corsydol but think I will stop because even though I dilute it, it's still really strong and I feel it's causing my mouth some irritation at present.

I do worry about losing my teeth, I must admit. Especially considering that I have good BG control and good dental hygiene but yet still get sore flamin' gums

 

[K8tie_x]

I've also had problems with my teeth.. The dentist has prescribed a special toothpaste for me which I'm hoping is going to help! Good luck!

 

[victry77]

I'm a dental nurse, the most common reason for decay is eating in between meals. Teeth can withstand 3 sugar attacks a day, this includes fruit and acidic items, so if your snack between meals is acidic or has some sort of sugar in it, including drinks, your risk of decay is higher, if you suffer with hypos during the night this is most harmful as our saliva stops during the night and has remineralising agents in it.

If your flossing everyday, brushing twice a day, and avoiding sugary snacks, which we all know isn't always easy, use a toothpaste with at least 1450ppm sodium fluoride in it ( stated in ingredients).

I'm type 1 and luckily never had a problem with my teeth or gums but I have done this job for 10 years and been diabetic for 17 ( I'm 27) and I have only just in the last 3 years got my hba1c into single figures so if you get a good oral hygiene routine going, you should should see improvements.


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Hi niknak, would you say that rinsing your mouth out with water after eating (esp anything sugary) helps at all? I got into that habit a while ago. If I've taken a sugary drink for hyp, for example, as soon as I feel better the first thing I do is give my mouth a swill with some water. Don't know if it helps, though, in just getting rid of any excess sugar hanging around my mouth.

 

[niknak15]

Hi Victry,

The 'book' says to wait half hour then brush as it takes half an hour for the ph in the saliva to go back to a safe level but I go back to bed straight away after a night hypo ( naughty I know) so I tend to rinse with a fluoride mouthwash before going back to bed, not as effective as brushing but obviously better than not doing anything.


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[hale710]

Rumour I heard (could be wrong!!) is that if you've had something acidic like fruit juice you should follow it up with a small piece of cheese. It neutralises the ph.

All good in theory, I bloody love cheese so any excuse will do haha


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[ann34+]

Hi all,

Last week a routine check up resulted in a tooth extraction... Since diagnosis i've lost 2 teeth that were root filled due to root infections, and I also have gum disease which my hygienist is now helping me sort out, but this has only come about since being diagnosed. I am acutely aware of maintaining good dental hygiene with having type 1, as infections can cause high BG readings, and so follow a virtually sugar free diet, do low carb, keep a good HbA1c etc - but still annoyed i've lost a second tooth. Has anyone else had dental issues and any advice apart from regular brushing, flossing !!)

(This was all in a week of also finding out I have background retinopathy - so have written off last week as bad luck..)

Hi, although in another thread i said i did not have common complications, my teeth probs were constant, for years, and all root canal work failed in a short time, even when done at dental hospital. The problems were put down to having years of problems before being diagnosed, which set decay, and gum problems, in motion. I dont know whether this might apply to you.