The Importance of Dental Care for Diabetics

Counting carbs. Blood glucose testing. Possibly juggling several different types of medication. You may be so busy taking care of your diabetes that it's easy to forget about one very important part of your body: your mouth.

Both "dry mouth" and periodontal disease are very common among diabetics, says  Maritza Dominguez, DMD, dentist who treats many patients with diabetes. If periodontal disease gets out of control, she warns, it can adversely affect blood sugar control.

What causes gum disease? In diabetics, it can be a combination of plaque on the teeth and a weakened ability to fight off germs. It's kind of a double whammy: poorly controlled blood sugar levels may worsen gum disease, and gum disease also has a detrimental effect on your ability to control diabetes.

"Periodontal disease can have a bad effect on blood sugar," Dominguez explains. "When a patient has gum disease, there's a lot of inflammation, so we try to get that under control first."

Dry mouth, a syndrome in which the flow of saliva in the mouth is diminished, is also common in diabetes, Dominguez says. "So you see rampant decay in some people with diabetes," she explains. "A lot of them are people in their 40s and 50s who may have had root canals so if the decay progresses, they don't always feel it."

People with diabetes tend to lose their teeth at an earlier age, says Luigi Meneghini, MBA, MD, endocrinologist at the Diabetes Research Institute in Miami. "Part of this may be related to blood glucose control, or to the fact that they have had diabetes for a long period of time," he says. "They need more aggressive followup with a dentist and sometimes treatment t with antibiotics to get rid of the bacteria that come with periodontal disease."

While dental woes can definitely occur, they're much less likely if you take steps to protect your teeth. Here are some things you can do to help preserve your beautiful smile.

● Check with your dentist to make sure that you are brushing and flossing the right way. "There are correct and incorrect ways to do this," Meneghini says. "Be sure to follow your dentist's instructions." Your goal? To brush away the harmful plaque that builds up and causes gum disease.

● Visit your dentist regularly, depending upon what he or she recommends. Some dentists want you in there every six months but if you have periodontal disease, you may be put on a three-month recall. "I see patients every three months until they are stabilized," says Dominguez. "After that, I have them come in less often."

● Consider buying a special toothpaste and rinse for dry mouth, says Dominguez.

And if you're not sure whether or not you have gum disease, here are some signs to watch out for:

● Bleeding gums when you floss or brush

● Red, tender or swollen gums

● Gums that are pulling away from the teeth

● Loose permanent teeth

● Bad breath

● Changes in the fit of your dentures or bridges, or in how your teeth fit together when you bite.

If any of these happen, see your dentist right away.


"Living with Diabetes"