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Dental care and diabetes: Guide to a healthy mouthFrom MayoClinic.com
Special to CNN.com
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
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
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:
Your teeth and gums aren't the only parts of your mouth at risk. The following problems also can occur — and while you might not be able to totally prevent them, you can minimize the trouble they cause you.
Dry mouth also causes tissues in your mouth to become inflamed and sore. You may find that chewing, tasting and swallowing become difficult. If this reduces your interest in eating, it can make controlling your diabetes more challenging, since you may not eat properly and keep your blood sugar in control.
Your dentist may suggest an artificial saliva substitute to relieve the discomfort from dry mouth. Sucking on sugar-free candy or chewing sugar-free gum and frequently drinking water also may help ease dryness.
To treat the infection, your dentist or doctor can prescribe an antifungal medication that you let dissolve in your mouth, or one that you take in pill form.
Smoking and wearing dentures all day and night increases the risk of thrush. Not smoking and limiting the time dentures are worn can reduce your risk of getting thrush.
Oral lichen planus
Although there is no permanent cure, your dentist may prescribe a topical anesthetic or other medication to reduce or relieve symptoms.
Burning mouth syndrome
Dry mouth and candidiasis can cause burning mouth syndrome, so treating these conditions can alleviate the symptoms. Medications also may be prescribed to relieve the pain.Oral surgery and diabetes: A delicate mix
If you need oral surgery, diabetes — particularly if poorly controlled — can complicate such surgery. Diabetes retards healing and increases risk of infection.
Your blood sugar levels also may be harder to control after oral surgery. The levels may fluctuate as a result of the stress of the surgery and inability to eat your normal diet due to discomfort.
Keeping your blood sugar levels under control before and after the surgery reduces the risk of such complications. Your dentist also may need to work closely with your doctor to minimize possible complications.
If you need oral surgery, follow the American Diabetes Association's recommendations:
If you have diabetes, you likely know the need to take certain precautions to keep your body working properly. To enjoy better oral health — which in turn can help keep your blood sugar in control — also treat your mouth and teeth with extra care and see your dentist regularly.
May 26, 2006