Gum Diseases & Tooth Loss in Diabetic Patients – Dr Marini Ismail

You’re probably aware that diabetes is a disease that can affect the whole body including your eyes, nerves, kidneys, heart and other important organs in the body. But did you know that diabetes can also cause problems in your mouth? The most common mouth problems from diabetes is gum disease. Gum disease can lead to painful chewing difficulties and even tooth loss!

Gum disease is mainly caused by plaque and poor dental hygiene. Plaque is a sticky film of saliva, food and germs that accumulates on teeth both above and below the gum line which gives risk for gingivitis. When plaque stays put, it hardens into tartar (calculus). Both dental plaque and tartar are filled with harmful bacteria, and if they aren’t removed, they will begin to irritate the gums and cause gingivitis. Gingivitis is the first stage of gum disease. If plaque and tartar are not cleaned away and gingivitis is left untreated, it may lead to inflammation and destruction of tissues surrounding and supporting teeth, gums, bone and fibers that hold the gums to the teeth, causing the more severe form of gum disease called periodontitis. Teeth may become loose and need to be removed. Because gum disease is often painless, you may not know you have a problem until you have some serious damage.

Gum disease is more common and more severe with people who have poorly controlled diabetes. Therefore, they tend to lose more teeth than thoseb whose diabetes is well-controlled.

Please see your dentist immediately if you have diabetes and notice any signs/symptoms of gum disease, including:

• Red , swollen or tender gums
• Loose teeth
• Frequent bad breath (halitosis)
• Receding gum line- Teeth may look longer
• Teeth moved from original position
• Spaces opening up between your teeth
• Pus between the teeth and gums (when you press on the gum)
• Ill-fitting partial dentures
• Changes in the way teeth fit together when biting

Factors that link diabetes to gum disease are:

• Poor oral hygiene is a major factor in gum disease for everyone, but it is more severe with a person with diabetes.
• Diabetes may affect the structure of the blood vessels and slows the circulation, which make the gum tissues more susceptible to infections.
• Diabetes will reduces the body’s resistance to infection which increases the possibility of the gums becoming infected.
• High glucose levels in saliva promotes growth of bacteria that can cause gum disease.
• People with diabetes and smoke are far more likely to develop gum disease than people who smoke and do not have diabetes.

The other types of most common oral health problems affecting people with diabetics including:

• Gum abscess
• Tooth decay (dental caries)
• Fungal infection such as thrush (Candidiasis)
• Lichen planus (an inflammatory skin condition)
• Mouth ulcers
• Taste disturbances
• A dry, burning mouth (low saliva levels)
• Poor healing of oral tissues

Suggestions to prevent/reduce oral health problems include:

• Follow your doctor’s advices about diet and medications to keep your blood sugar as close to normal as possible.
• Visit your dentist regularly at least twice a year for advice about proper home care, early intervention and regular preventive maintenance visits to keep your teeth and gums healthy.
• Make morning appointments for dental treatment , eat and take your medications as directed. Dental procedures should be short and stress free.
• Show your dentist a list of all the names and dosages of the medicines you are taking. Your dentist need to know this information to prescribe medicines that are least likely to interfere with the medicines you are taking.
• If your blood sugar is not in good control, postpone non-emergency dental procedures unless there is an acute infections which develop quickly such as abscess, it should be treated right away.
• Avoid having a dry mouth by drinking plenty of water or chewing sugar-free gum to help keep the the saliva flowing.
• Stop smoking.
• Use a soft-bristled toothbrush and replace it every 3 months.
• Brush for at least 3 minutes twice daily with fluoridated toothpaste, or after each meal if possible.
• Floss at least once a day.
• If you wear dentures, keep them clean and take them out at night. Have them adjusted if they become loose or uncomfortable.

Dr. Marini Ismail is a dental officer currently working in Selangor.

 

[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]

 

References:

• http://www.diabeticlifestyle.com/diabetes/diabetes-dental-complications
• http://www.webmd.com/diabetes/dental-health-dental-care-diabetes
• http://www.hopkinsmedicine.org/healthlibrary/conditions/diabetes/diabetes_and_periodontal_gum_disease_85,P00349/

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