Dental Health and Diabetes

 

This fact sheet is designed to answer questions relating to diabetes mellitus and the effects it has in the mouth. Diabetes Mellitus is a condition whereby the sugar (glucose) from food is not used by the body. The reason the body is not able to use the sugar could be due to one of the following:
  • Type I Diabetes. The body does not produce enough insulin (a hormone that is needed to absorb glucose).
  • Type II Diabetes. The cells in the body donít interact with the insulin.
Therefore, the type of diabetes an individual has will dictate how it can be controlled. Those people who do not produce enough insulin can receive insulin injections. Individuals whose cells donít react with the insulin can try to control their diet and the types of food they eat (reduce the amount of sugar and fat).

A disease such as diabetes effects the entire body including the mouth. Here is some information in a question and answer format that may shed some light on how diabetes effects the teeth, gums, and breath.

Q: Are Diabetics More At Risk For Getting Cavities Than Non-Diabetics?

A: Not necessarily. If the condition is monitored and controlled, the diabetic is at no greater risk for getting cavities than a non-diabetic.

If the condition is not controlled, and the diet consists of foods high in sugar and starch, the diabeticís chance of getting cavities will increase. It is understood that diabetics sometimes eat smaller meals, requiring more meals per day. This means frequent doses of sugar (in various forms) throughout the day. A diabetic needs to ensure he/she brushes their teeth after every meal and flosses at least daily.

Some diabetics have noted their mouths feel dry. If this is the case, then the risk of cavities is definitely increased. Normally, saliva washes over the teeth collecting some (not all) sugar and is then swallowed. Without enough saliva in the mouth, sugar is allowed to remain on the teeth. This allows the sugar an opportunity to cause decay.

Q: What Can Gum Disease Mean For A Diabetic?

A: Diabetics are known to have a decreased dental healing response. Gingivitis is an infection within the gums caused by bacteria found in plaque. A diabeticís body doesnít respond as quickly to fight this type of infection as a non-diabetic. If the infection persists it can become worse leading to the infection of underlying bone that anchors the teeth in place. It has been shown that diabetics who keep their condition under control have a better chance of combating infections that those who are poorly controlled.

In addition to controlling the condition of diabetes, the importance of maintaining good oral health is essential. Brushing and flossing help to reduce plaque and bacteria that cause infection and thereby decreasing the risk of gum disease.

Q: Will A Diabetic Lose Their Teeth Sooner Than A Non-Diabetic?

A: Many factors contribute to the loss of teeth in someone who has diabetes. A poor healing response combined with gum disease and the destruction of bone anchoring the teeth in place may result in teeth that become loose and eventually fall out. Although diabetics have no control over their response to infection, they can practice good oral hygiene habits (brushing and flossing). Removing plaque will reduce or eliminate infection. Ensuring the diabetes is controlled (taking insulin, altering diet) is also a way of decreasing the risk of tooth loss.

It should be noted that a diabetic may have excellent oral hygiene and still suffer from gum disease and bone loss. If this is the case, additional measures can be taken. A dental hygienist can recommend a special prescription mouthwash which kills various bacteria in the mouth that contribute to gum disease. Your dentist can write the prescription. Diabetics should be encouraged to ask their hygienist any questions they have regarding their oral health status.

Q: Many Diabetics Have Unpleasant "Fruity-Sweet" Smelling Breath. Is There Anything They Can Do About It?

A: Unfortunately, no. The "fruity-sweet" breath is caused by the disease itself as a result of the bodyís natural defense against decreased glucose use. There are some methods of masking the odor, but they are only temporary and do NOT eliminate the problem. Some things that may help are:

  • sugarless chewing gum
  • using a mint flavored  mouthwash
  • brushing frequently
While there are many other concerns that people with diabetes may have, these are the basics pertaining to the oral health. If you have any questions that have not been answered, or would like more detail, please donít hesitate to contact Dr Talcott.  
 

This site is intended as general information only and should not
replace regular consultation with Dr.Talcott or the
Dental Hygienist. Copyright © 2003 Dr Bob Talcott, DDS

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