Diabetes and Oral Health
Your mouth doesn’t lie. Swollen, bleeding, or receding gums; loose or missing teeth; and persistent bad breath are all signs of gum disease. If you have diabetes, you’re at higher risk for both gingivitis (early-stage gum disease) and what’s known as periodontitis (advanced gum disease).
Both start with plaque, a soft, sticky substance that accumulates on your teeth as you eat and is made up mostly of bacteria. More than 500 types of bacteria can be found in plaque—some are good for your mouth and some aren’t.
Bacteria in a person with diabetes is no different than people without doesn’t have diabetes. The difference is in the nature and intensity of the body’s inflammatory response to the bacteria. If you have diabetes—especially if you’re not meeting your targets—you will have more of an inflammatory response, which could result in a loss of supporting tissue for your teeth. Eventually, the tooth could become so loose it has to be removed.
There are some oral conditions that are more common in people with diabetes, such as dry mouth. It may be a result of aging or medications, but it could also be a complication of diabetes. Whatever the cause, the lack of saliva from dry mouth means food debris, sugar, acid and bacteria don’t get washed away as easily.
There is good news, though: None of this happens right away. And there’s plenty you can do to prevent gum disease. If you manage your diabetes and your oral health by getting regular checkups with a dentist or periodontist, you will reduce your risk.
What can you do now?
Here are three essential steps to maintaining a healthy smile:
- Brush twice a day. The American Dental Association recommends brushing for two minutes, twice a day, with a fluoride toothpaste. Place your toothbrush at a 45-degree angle to the gums and gently move the brush back and forth along the outer, inner and chewing surfaces of your teeth. Be sure to clean each surface thoroughly. Whether you use a manual or electric brush doesn’t matter, but the size and shape of your brush should make it easy to reach all areas. And be sure to use soft bristles. Research shows that firm bristles tend to wear away the enamel on your teeth.
- Floss once a day. If you don’t, plaque and food particles build up between teeth and along the gum line, setting you up for tooth decay and gum disease. To floss, wind an 18-inch piece around your middle fingers, leaving an inch or two to work with. Holding the floss between your thumbs and index fingers, curve it around each tooth in a C shape and gently slide it up and down the tooth and beneath the gum line. Not a fan of flossing? Try an interdental device. The tiny brush is designed to reach places a regular toothbrush can’t.
- See your dentist twice a year. Depending on the health of your gums, he or she may recommend cleanings every three months. Your dentist may also suggest an antibacterial mouth rinse or antibiotics. Be sure to let your dentist know of any changes in your health or medications because both can affect your oral health—such as symptoms of dry mouth.
Know before you go
Check out these four ways to get the most out of your next dental appointment:
- Find a dentist who is aware of the needs of people with diabetes.
- Be honest with your dentist. Your dentist needs to know if you’ve been reaching your diabetes targets since it will affect how you’ll respond to dental treatments.
- Be sure to eat normally prior to your appointment and take your usual meds on schedule.
- Be proactive. When you go in for a cleaning, ask: How do my gums look? Was there a lot of bleeding? Is there anything more I should be doing? You’re the most important part of your diabetes care team—and that’s also true when it comes to keeping your teeth and gums healthy.
Did you know?
Did you know that it’s possible for your dentist to refer you to your doctor to get screened for prediabetes or type 2 diabetes? A study published recently in BMJ Open Diabetes Research & Care found that nearly 1 in 5 people with severe gum disease had type 2 diabetes and didn’t know it.