Diabetes and Dentistry

Publication: Montana Woman Magazine

This month, I would like to discuss a disease that affects someone you know or love. A metabolic disease called diabetes. Current research is proving what we have known all along. The health of your mouth is directly connected to the health of your body, in many ways. The diseases we have, can affect the health of the mouth in many ways also. Diabetes is one of these conditions that can affect the health of every organ in the body! I will review the relationship between diabetes and oral health, and hopefully save a tooth or a life.

Diabetes is a serious, common, controllable illness. It is the 6th leading cause of death in the U.S. It is the #1 cause of lower limb amputation not related to trauma, the #1 cause of blindness, and kidney disease leading to dialysis. Diabetes is a leading contributor of cardiovascular disease, which is the leading cause of death in the U.S. 65% of diabetics die from cardiovascular disease. Adults with diabetes are 2 to 4 times more likely to have heart disease or suffer a stroke than non-diabetics. They are at risk for kidney disease, amputations, nervous system disease, and gum disease.

There are two main types of Diabetes. Type 1 and Type 2.Type 1 diabetes (also known as juvenile or insulin dependent), begins in childhood or young adult hood with the autoimmune destruction of the insulin producing cells in the pancreas. These people need insulin and must check their blood sugar frequently. Diet plans and exercise are part of their life. Type 2 diabetes (adult onset or non-insulin dependent diabetes) is related to insulin resistance. This is where the body produces insulin but it is not well used by the body tissues. Insulin production gradually decreases. This tends to affect overweight and sedentary people, and is alarmingly becoming more common in young people. This is a concern because the risk of complications increases with the duration of diabetes.

Diabetes can lead to changes in the oral cavity. Unfortunately, caring for the mouth is frequently overlooked in the treatment of diabetes. The effects of diabetes on the gums and other oral tissues may be noticed by your dentist. Unfortunately for many people, gum disease has few symptoms and may go unnoticed until it is quite severe. Other conditions may include dry mouth, aggressive periodontal disease, saliva changes, burning mouth syndrome, abnormal wound healing, fungal infections and tooth decay. These findings are associated with dehydration from excessive urination, altered response to infection, altered tissue metabolism, micro vascular changes, and side effects from medications.

It has been shown that diabetics have a decreased immune response. The result of this is increased risk for infections. The double whammy here is that infection makes blood sugar harder to control. Uncontrolled blood sugar makes infection more possible. Add on to this conundrum some dry mouth and poor oral hygiene and we may have a serious health risk in your mouth. Decayed teeth may crumble bacteria into you lungs and give you pneumonia. Gum disease is more common and more severe in diabetics, and is harder to treat. To make matters worse, periodontal disease increases risk from heart disease and stroke, on top of the risks posed by diabetes. Don’t forget, uncontrolled gum disease makes it harder to control blood sugar, increasing risk for organ damage to the brain heart and kidneys!

Whew, if you have waded through all this bad news you deserve some good news! Diabetes is controllable, and in the case of type 2, frequently preventable. The same goes for gum disease. That’s why prevention is worth the trouble. When blood sugar is controlled, a diabetic is like everyone else, except they pay more attention to food and blood sugar. I have many diabetics in my practice, and they are great people, partly because they appreciate health that others may take for granted. There are 20 million diabetics in the U.S. and many undiagnosed cases. Great oral hygiene and professional dental care can make the difference, so brush, floss and see your favorite dentist regularly!