Four oral health problems for diabetics.

By Dr George Druttman

Diabetes and Dentistry

Diabetes is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period of time.

It is a lifelong condition that left untreated can cause many complications such as heart disease, stroke, kidney failure, foot ulcers and damage to the eyes. In England in 2010, there were approximately 3.1 million people aged 16 or over with diabetes (both diagnosed and undiagnosed). By 2030, this figure is expected to rise to 4.6 million, with 90% of those affected having type 2 diabetes.[1]

For people living with diabetes, dental care is even more important and vital, as they face a higher than-normal risk of oral health problems due to poorly controlled blood sugars. This is because uncontrolled diabetes impairs white blood cells, which are the body’s main defence against bacterial infections that can occur in the mouth.

So which dental problems are diabetics most at risk from?

1. Dry Mouth – Consistently high blood sugar levels is responsible for diabetics suffering from a dry mouth. Apart from being uncomfortable, a lack of moisture in the mouth can encourage the growth of bacteria.
2. Bad Breath (Halitosis) – There are numerous reasons as to why someone may suffer from bad breath, but it is often caused by a build up bacteria in the mouth. Bacteria in your mouth digest food particles and glucose and release a foul odour as they do so. Diabetics with high blood sugar levels can encourage the growth of bacteria in the mouth as they have a higher presence of glucose in their saliva for bacteria to feed off. With bad breath and a dry mouth encouraging the growth of bacteria, this is bad news for maintaining your oral health as the presence of bacteria can lead to tooth decay and gum disease.

   

3. Gum disease – This is one of the lesser know complications for people suffering with diabetes and it is estimated that 1 in 3 diabetics suffer from periodontitis (gum disease) as some point.[2] The reason as to why diabetics are prone to periodontal diseases, is that when a body is suffering from diabetes, the structure of blood vessels is altered. This effects the efficiency of the blood flow to the mouth, leaving the gum and bone weaken. A correlation between bacteria in the mouth and gum disease has also been made and as discussed before, diabetics are already at risk of increased levels of bacteria in their mouths.
4. Tooth Decay – The same bacteria that causes gum disease causes tooth decay and the two conditions are closely linked. Tooth decay is a bacterial infection of the mouth that can result in the decay of the teeth. Tooth decay is actually one of the most common diseases in the world, and as it is caused by bacteria, diabetics are more at risk, because of high sugar levels increasing the amount of glucose present in their mouths, which is the food source for bacteria. Tooth decay is caused by the bacteria in your mouth combining with small food particles and saliva to form plaque. If this plaque is allowed to build up the acid can begin to break down the outer surface of your tooth and can eventually enter and damage the soft part at the centre of the tooth.

What can one do to minimise oral health problems?

• The best way to prevent oral health problems is to employ a good oral hygiene technique which would include brushing your teeth twice a day and flossing.
• Avoid sugary foods, snacks and drinks. This will help prevent the growth of bacteria as they would have less glucose to feed off.
• Maintaining good control of blood sugars will prevent hyperglycaemia and stop excess saliva glucose which can also feed bacteria.
• Visit your dentist regularly. A thorough clean from your dentist will remove plaque you have failed to remove at home and any tartar which is a build up of hardened plaque. Your dentist will also be in the best position to check that your at-home hygiene technique is up to scratch and can help you improve.

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