Diabetes and Dentistry

Miranda Schwartz
1 March 1998

Reduced Salivary Flow

Patients with diabetes may also experience dry mouth as a result of reduced saliva. Neuropathy and certain medications may be the cause of reduced salivary flow. Finney says that saliva is important to wash residue off teeth and gums and prevent tooth and gum disease. Ask your dentist about products that moisten the mouth or increase saliva.

Drinking lots of fluids may help alleviate the problem and there are products available that can help keep the mouth moist.

It's All Connected

The development of periodontal disease may reflect the presence of other problems related to BG control such as retinopathy.

"Retinopathy and dental problems are closely related. If you look at a population that is having eye problems, that same population is likely to have dental problems. If a person is diagnosed with retinopathy, they should make sure that their mouth is being examined and the gums are healthy. Conversely, if there is serious gum disease there may be other diabetic complications taking place in the body," says Finney.

Problems that begin elsewhere in the body should also provide clues for health care professionals. The presence of microalbuminuria and neuropathy are signals to check the mouth for potential complications.

Prevention

As with all diabetic complications, an ounce of prevention is worth its weight in gold. By far the most important step that can be taken is to brush and floss regularly. It is advisable to discuss proper brushing and flossing techniques with your dental team. Some of the fundamentals might surprise you. For example, it is recommended that you brush for a minimum of three minutes, which, when put into practice, is longer than one might imagine.

In the Chair

Prevention also includes making and keeping the often dreaded dental appointment. Finney suggests seeing the dentist twice a year, or as often as necessary. If you are avoiding the dentist due to fear and or loathing, see below for some strategies to make it a little easier to deal with.

It is best to schedule dental appointments, about an hour and a half after breakfast so that the appointment does not interfere with regular meal times. Test your BGs before you go to the dentist and test them while you are at the dentists office. Make sure to stick to your regular insulin and/or oral medication schedule to avoid BG problems. It is also important to discuss your diabetes with your dental team.

Once at the dentist, voice concerns and report any abnormality, such as gingival bleeding. Healthy gums are usually light-pink, snug around the tooth and don't bleed.

Treatment

If an infection is already present, it must be treated before any significant procedures can be attempted. Once diabetes is under good control, oral surgery can be performed without complication.

Dentures

Since periodontal disease can lead to tooth loss, many patients are fitted for dentures. Patients wearing complete dentures should see the dentist once a year to examine all soft tissue areas. Partial dentures require attention to hygiene just like real teeth. They need to be removed and cleaned daily.

Wearing dentures continuously and failing to take the proper precautions can promote the growth of mouth fungus (candidal colonization) leading to thrush.

Dentures may also be ill-fitting and uncomfortable. This is because the gums of people with diabetes may be especially sensitive. This in turn makes eating, and maintaining good health and proper BG control more difficult.

Dental implants can be another viable option for tooth replacement for people with diabetes.