Diabetes and dental problems
December 07 2017 09:05 PM
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By Dr Shahid Khalid

It is estimated that up to 20 million people have diabetes, but only two-thirds of these individuals are diagnosed. Clinical studies have shown that diabetes is linked to many long-term complications and one of them is reducing the body’s resistance to infection. This makes the relationship between oral health and diabetes to be complicated. Recent studies mention that people with diabetes are more prone to teeth and gum problems.
Maintenance of a good dental health is of utmost importance in the prevention of dental complications. Looking after your teeth and gums is an essential part of learning to live with both Type 1 diabetes and Type 2 diabetes.
Any unfavourable dental changes should be immediately brought into the notice of your dentist as this has a great influence on the treatment plan. The sooner the changes are identified, quicker would be the response to the treatment and better would be the outcome.


Diabetes and dental hygiene
People with diabetes who have poor control of their blood glucose levels are more likely to develop dental health problems. Therefore keeping your blood sugar within a normal range will reduce this risk. Eating a balanced diet, getting regular exercise and giving up smoking are also advised to lessen the risk of oral health problems.
Making sure that you visit a dentist every six months ensures that any infection will be treated as early as possible. Minor dental problems can quickly escalate, and a routine visit to the dentist will pick up on these.
People with diabetes should see their dentist in the event of any of the following:
l Any problem with the gum
l Bad odour of the mouth
l Unpleasant taste in the mouth
l Mobility of the teeth or sudden spacing between the teeth
l Sensitivity with hot and cold drinks
l Dental decay or any mouth infection
You should visit your dentist if you experience any of these symptoms; urgent treatment might be required to prevent a problem from worsening.


Diabetes and gum diseases
Gum disease, also known as periodontitis, is the sixth most common disease in the world. It occurs when bacteria within the mouth begins to form into a sticky plaque which sits on the surface of the tooth.
A gum disease is classified on the severity of its development. There are three stages of gum disease:
1. Gingivitis: Gingivitis is the initial stage of gum disease, caused by poor oral hygiene and irregular plaque removal from teeth. It is characterised by swollen, red and tender gums and it can cause bleeding when brushing. Luckily gingivitis is reversible, and through improving your oral hygiene techniques and visiting your dentist or hygienist for advice on a home dental health care programme, you should be able to reverse this process.
2. Periodontitis (mild): Untreated gingivitis can lead to mild periodontitis. The conversion of gingivitis to periodontitis is more common in people who have a family history of gum disease, poor oral hygiene and uncontrolled diabetes. At this stage there will be damage to the gums and bone supporting the teeth. In order to prevent further damage a prompt visit to the dentist is required to prevent further progression.
3. Periodontitis (severe): This is the most advanced stage of gum disease, characterised by significant tissue and bone loss around the teeth.
Having prolonged high blood glucose levels can lead to gum disease developing or worsening more quickly, but keeping your levels within a normal range reduces the risk of infection spreading.
Unfortunately, when your body begins to fight an infection, blood glucose levels will usually rise in response. Should the infection in your mouth become worse, you could have problems with food intake, which might affect your diabetes management.


Treatments
A routine dental examination once at an interval of three months is highly recommended for the early interception and prevention of any oral infection from developing.
If you are on medication that can lead to hypos, such as insulin peak should be communicated to your dentist so that he/she could carry out the necessary treatment modifications before the dental work.
High blood sugar levels may affect the time the gums take to heal. For example, if you have a tooth removed, and it is taking an unusually long time to heal, you should immediately contact your diabetes healthcare team or dentist for advice.

* Dr Shahid Khalid, BDS, 
MDS (Prosthodontics and 
Crown & Bridge), is a Dental Surgeon at Aster Medical 
Centre, C Ring Road



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