Diabetes and Mouth Care
Diabetes Mellitus is a chronic metabolic disorder characterized by a relative
or absolute lack of insulin that results in elevated blood glucose levels and it
produces disturbances in lipid and protein metabolism.
With increasing disease prevalence, it has become critical for the dental
practitioner and other health professionals to.
1. Recognize signs and symptoms of diabetes, to facilitate early diagnosis and management.
2. Manage oral conditions, to maxima.
1. Diabetes and mouth
Infection, inflammation and poor wound healing in the mouth are some
manifestations of diabetes. Besides hypoglycemia, ketoacidosis and vascular wall
disease increases susceptibility to infection.
There is increased incidence of persistent gingivitis, periodontal abscess and
chronic periodontal diseases. Because micro vascular disease in periodontium
adversely affects blood flow and leukocyte migration, predisposing to premature
periodontal disease, abscess and delayed wound healing, oral candida also
occurs more frequently in diabetics due to altered response to infection and
xerostomia.
Burning tongue can be due to fungal infections such as candidiasis, or peripheral neuropathies,
Associated with diabetes, xerostomia may be due to hyperglycemia and subsequent polyuria that
depletes extracellular fluids, which leads
to reduction in secretion of saliva.
Good glycemic control and meticulous home care are cornerstones in the prevention and care
of oral ulcers, infections, dental caries, and alveolar bone loss
because of periodontities associated with diabetes
2. Periodontal disease
Periodontal disease is a chronic bacterial infection that affects gum and bone
supporting teeth. It is a serious infection that, if left untreated, can result in
tooth loss. In untreated cases, periodontal disease can be life threatening for
diabetic patients. The disease can affect one or many teeth. It begins when the
bacteria in plague-the sticky, colorless film that constantly forms on teeth- cause
the gums to become inflammed.
Gingivitis is often caused by inadequate oral hygiene and is reversible with
professional treatment and good oral home care. Untreated gingivitis can advance to
periodontities. Gums separate from teeth, forming pockets-spaces be-
tween teeth and gum- that become infected. As disease progresses, the pockets
deepenn and more gumm tissue and bone are destroyedd. Teeth can become loose,
the way the teeth bite together may change and teeth may be lost.
3. Factors influencing the health of gums
Several factors influence the function of teeth and gums. Some are man made
and the others natural.
• Genetics
• Pregnancy and Puberty
• Smoking and tobacco use.
• Stress
• Medications.
• Clenching and grinding teeth
• Diabetes.
People with diabetes are more likely to have periodontal disease than are people
withoutt diabetes, probablyy because diabetics are more susceptiblee to contracting infections.
Those people who don’t have their diabetes under good control are especially at
risk of dental and periodontal problems. A recent study demonstrated that poorly
controlledd Type 2 diabetic patientss are more likelyy to develop periodontal
disease than those who have good control of diabetes.
• More than half of all adults have, at least, early stages of gum disease.
• About 90 percent of adults have gum disease at some time during
their lives.
• People with diabetes are at higher risk for gum problems and tend to
have more gum disease and infections.
• Patients can be educated about gum disease and its prevention, and it
is here that the medical professional plays an important role by encouraging
meticulous daily oral hygiene practice.
• Patients should be alerted of early signs of gum disease, such as
bleeding or slight gum discomfort.
• Six monthly dental visits are important; more often if there are
problem.
• For edentulous (without teeth) patient, yearly visits are recommended
for checking the health of the tissues and to detect possible infection.
4. Oral Hygiene in Diabetes
Long term studies have proven the value of consistent and regular oral hygiene
care routines. Regular and timely dental visits are imperative to reinforce those
habits and to minimize oral health problems. The basics of oral care for all
people include brushing, flossing, mouth rinsing and tongue cleaning. Special
care in many of those areas is of utmost necessity for people with diabetes.
4.1 Tooth brushing
Teeth should be brushed at least twice daily with soft brush. If possible,
teeth also should be brushed after meals. The use of a brush with soft bristles
is very important. Stiff bristle or too rigorous brushing can damage the gums
and increase potential problems.
4.2 Flossing
Patients also should be encouraged to floss. Ideally teeth should be flossed at
least once daily. Again, a wide array of flossing products are available. Several
types of flossing tools designed to make flossing easier are also available.
4.3 Mouth rinsing without alcohol content
Mouth rinsing also can be a part of good oral health, but should be taken to
select a mouth rinse that meets the patient’s specific needs. Some mouth rinses
have fluoride and are intended to decrease cavities. Those mouth rinses typically
have little effects with regard to gum disease and bad breath. Other products
are intended to be used before brushing and are for the purpose of increasing
the effectiveness of brushing. For people with diabetes the greatest areas of
concernn tend to be with gumm disease and bad breathh. Those people need a mouth
rinse that addresses bacteria and by-products of bacteria that contribute to gum
problem.
• The relationshipp betweenn diabetes and periodontal disease goes both
ways, each making the other more difficult to manage.
• Peoplee with diabetess are at higher risk of gum disease.
• Diabetes should use a toothbrush with soft bristles.
• Alcohol in mouth rinses can dry mouth and result in exacerbation of
oral health problems.
• The tongue also can harbor bacteria and regular tongue cleaning is
recommended.
5= Conclusion
People with diabetes are more likely to have periodontal disease than are people
without diabetes. Furthermore, studies have found a link between periodontal
disease and coronary artery disease in Type 1 diabetic adults.
Thosee peoplee who don’t have their diabetess under control are especially at risk.
Poorlyy controlledd Type 2 diabetes patients are more likelyy to develop periodontal
disease than are well-controlled diabetes.
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