How does diabetes affect my oral health?

As a person with diabetes you are at a much greater risk of gum disease, which if not treated can result in tooth loss. As many as 95% of people with diabetes have a gum disease known as periodontal disease or periodontitis.

The more common symptoms of the disease include:

  • Red, swollen or puffy gums (healthy gums are pale pink)
  • Bleeding gums, especially when brushing or flossing the teeth
  • Bad breath
  • In the more advanced forms, teeth may look longer or feel loose

Diabetes weakens the body’s natural ability to fight inflammation and infection. Healthy gums provide a barrier to the bacteria in the dental plaque that accumulates on the surface of your teeth. If the plaque is not completely removed by thorough oral hygiene the bacteria attack the gum tissues, causing them to be inflamed. As the barrier breaks down, bacteria then invades and infects the gum tissues.

As the gum tissues are infected, they become separated from their normally tight seal around the teeth. When this attachment is loosened, a space along the root of the tooth is formed and this space fills with more dental plaque. If the plaque gets beneath the gum tissue it becomes nearly impossible to remove with normal at-home care. Abscesses may occur, and the teeth will eventually need to be extracted to control the infection.

How should I maintain good oral health?

As soon as your physician has confirmed the diagnosis of diabetes you should arrange to see a dentist right away. Your dentist will evaluate your oral health and the increased risks of gum disease. Everyone is different, so they will create a personalized care plan that is right for you.

What else should I know about diabetes and my oral health?

There is a two-way connection between diabetes and gum disease. People with diabetes are much more susceptible to gum disease and people with gum disease are more likely to have diabetes. Poor glycemic control (blood sugar) in diabetes can make gum disease more aggressive and harder to treat successfully. Similarly, untreated gum disease can make it harder to achieve good glycemic control.

Questions to ask your dentist:

  • Is your oral hygiene and plaque control adequate, and if not, how can it be improved?
  • What is the state of your oral health, especially your gum health? Have you any pocket depths deeper than 4 mm (a sign that periodontal disease may be present)?
  • How often should you visit your dentist, your dental hygienist and your periodontist for evaluations and cleanings?
  • How might my gum health be affecting my diabetes and glucose control (A1C)?
  • What steps should you take before dental visits to prevent low blood glucose or other adverse events associated with diabetes?
  • When you visit your dental office, please bring a list of all medications and the name and address of your primary care physician and any other health care providers who you have seen in the last six months. Your dentist may also wish to know your A1C (blood glucose test) results.

If you have been diagnosed with diabetes – don’t delay – see your dentist and have your gum health checked right away! Many effects of gum disease cannot be reversed.

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