We truly live in a time of medical miracles. Diabetes, the set of conditions related to the regulation of blood sugar by the pancreas through insulin secretion, used to be a death sentence as recently as the middle of the 19th century. Today, it is a manageable condition through diet, exercise, and administration of supplemental insulin. However, those who have diabetes still need to be careful, monitoring their blood sugar levels and getting frequent checkups to ensure the proper medication dosage. Diabetes is a condition with long-term systemic effects; diabetics must realize that those effects on their oral health can be insidious.
One of the effects of diabetes is poor circulation, caused by high blood glucose levels and increasing fatty deposits in blood vessels.This poor circulation can affect gum health, causing gingivitis and periodontitis or inflammation of the tissue surrounding the teeth. Infection of the gums is exacerbated by an inability to bring the required antibodies and restorative nutrients to the affected site, and the weakening effect diabetes has on white blood cells. Gingivitis is the most common oral health condition in diabetics. Decreased circulation can also cause atrophy of gums, resulting in loose teeth.
Poor circulation can also cause decreased saliva levels, resulting in dry mouth. Dry mouth can cause soreness; ulcers; bad breath; sores and bleeding of the mouth, tongue, and gums; and thrush, a painful fungal infection of the mouth. The fungal growth is stimulated by the high sugar content of the saliva and worsened by the dry conditions associated with poor circulation. Smoking can make all of these problems worse and add complications to other aspects of diabetes. Smoking has even been known to cause Type 2 Diabetes.
If your tongue feels thick and dry, it may be that diabetes is affecting your tongue. You may also notice white patches on your tongue. These are called leukoplakia. Leukoplakia is when your body has too much sugar (glucose) in your bloodstream. Glucose is needed to make energy for your cells. But if you have high glucose levels, your body produces extra amounts of glucose instead of creating energy. This excess glucose builds up inside your cells and damages them. Leukoplakia can be treated if caught early enough but may not always heal completely. In some cases, leukoplakia can turn into cancerous lesions. Your dentist can check your tongue to find out if you have leukoplakia.
Another common oral condition associated with diabetes is excess sugar in the saliva. This sugar is the primary food source for bacteria in plaque, a sticky film on the teeth, which converts the sugars into acid, creating cavities in the teeth. This is another reason it is important to regulate blood sugar as a diabetic and mitigate the damage oral bacteria can cause by frequently brushing one’s teeth, using bacteria-killing mouthwash, and decreasing intake of sugary food and drinks. The good news is that diabetics are already monitoring and controlling their blood sugar levels to avoid more severe complications in other bodily systems.
One interesting thing to note is that one of the early symptoms of diabetes is poor oral health, specifically the conditions previously mentioned. Diabetes affects about 285 million people worldwide, but approximately one-third of adult diabetes cases in the United States are currently undiagnosed. Thus, a dentist can use these conditions as a diagnostic tool to warrant a test to see if a patient might have diabetes or be at risk for developing diabetes if other health factors do not improve. A dentist would then be able to do their part to encourage patients at risk of developing diabetes to take steps to alter their lifestyle or to manage better the condition of which they were previously unaware.
Diabetic patients should visit a dentist at least twice per year for regular checkups. A dentist can detect any issues early and treat them before they become severe. In addition, regular visits allow dentists to monitor how well the patient is healing after receiving treatment. When choosing a dentist, look for someone who has experience working with diabetics. Dentists who specialize in treating this population understand the unique needs of these patients and know how to best care for them.