Diabetes can affect your oral health in ways you might not expect.
First, when you have diabetes, it’s harder for your body to fight off infection, including gum disease. “Uncontrolled blood sugar lowers the healing response, which makes repairing gums and fighting off infection that much harder,” says Dr. Benjamin A. Lawlor of Maine Cosmetic Dentistry near Portland, Maine. “The mouth is the gateway to the body and is a perfect environment for bacteria to multiply.” Bacteria can then make its home in the gums. A healthy body finds it easier to fight off bacteria, but a body with disease (such as diabetes) or inflammation can’t fight that bacteria as easily. That can turn into a gum infection, Lawlor says.
Without the right treatment, this can lead to more serious gum disease, called periodontitis, and eventually result in tissue damage and even tooth loss, says Dr. Katia Friedman, owner of Friedman Dental Group, with several locations in South Florida. “Millions of people don’t know they have this serious infection that can lead to tooth loss if not treated,” she says.
The link between oral health and diabetes also works in reverse – in other words, having a serious infection may contribute to rising blood sugar levels. “This means that not only does having diabetes make an infection harder to fight, but also having serious gum disease may make diabetes harder to control,” Friedman says.
Plus, a high blood sugar gives bacteria an easier environment to grow. “Having a higher blood sugar can increase the availability of sugars and allow the bacteria a near-constant supply of food, and thus, constant destruction to the gums,” Lawlor says.
There are other ways that untreated diabetes affects your oral health, Friedman says. You may have a drier mouth, and that puts you at a higher risk for cavities. It may be harder for wounds in your mouth to heal, and you may have problems tasting food.
Here are some ways to take better care of your teeth and mouth when you have diabetes.
Control your blood sugar. This goes a long way toward better oral health, Friedman says. Work with your health care professional and diabetes educator to help in this area if you’re having trouble with it.
Watch for signs of gum disease. “The earliest warning of gum disease is when your gums bleed after brushing or flossing,” Lawlor says. Gum disease also can make your gums look bright red; plus, gum disease has a distinct smell, he adds. Other signs of gum disease shared by Friedman include:
- Gums that pull away from your teeth, causing your teeth to look longer than before.
- Loose or separating teeth.
- Sores in your mouth.
- A change in the way your teeth fit together when you bite.
- A change in the fit of partial dentures.
The good news is that most gum disease can go away with a little more vigilance in your oral care routine. “A couple weeks of thorough brushing and flossing is usually all it takes to reverse most early stages of gum disease,” Lawlor says. However, anything beyond that, and you’re better off seeing a dentist.
If you have gum disease that can’t get under control by better brushing and flossing, you may need to have scaling, an approach that removes plaque and tartar from below the gum line; or root planing, which smooths the tooth root and helps gums reattach to the tooth, Friedman says. Other treatments include lasers that help destroy bacteria and the use of antibiotics placed under to gums. More advanced cases may require gum surgery.
See a dentist every four to six months. “This is really the only way we can ensure that the gums stay healthy and avoid potential bone loss,” Lawlor says. Your dentist can take X-rays to check for bone loss and schedule regular cleanings. “The cleaning will flush out the bacterial homes and stimulate the gums to better health,” he says.
Those checkups every few months are a great time to let your dentist know about any changes in medications and any changes in your blood sugar control. “Postpone any non-emergency dental procedures if your blood sugar is not in good control,” Friedman advises.
Plus, dentists and dental hygienists can help explain better home care for your teeth. Speaking of that…
Set a regular home routine to clean your teeth. Brush twice a day and floss daily. Dentists also recommend the use of an electric toothbrush, which will do a better job of cleaning your teeth. When a patient has gum disease, Lawlor recommends an electric toothbrush with a soft head and other types of gum stimulation, including gum stimulators.
Rethink the need for mouthwash. Mouthwash choices abound, and some of them may help your mouth feel extra clean. However, a study published this December in the journal Nitric Oxide found that among 1,206 overweight study participants, those who used mouthwash twice a day were more likely to develop Type 2 diabetes within three years. (Those using mouthwash once daily only had a small and statistically insignificant increase in Type 2 diabetes development.)
Both Friedman and Lawlor caution that this doesn’t mean mouthwash causes Type 2 diabetes in everyone. In fact, there may be other factors at work. For instance, there’s a chance that some people who use mouthwash may have poorer health or possibly poorer diets, Friedman says.
However, mouthwash does break down bacteria in the mouth, including good bacteria, Lawlor says – and that works against better oral health.
“Mouthwash is often thought of as a harmless addition to daily tooth brushing, which helps to target plaque, but it is not listed as a necessary component of proper oral care,” Friedman says. “[The study] does ask questions as to whether mouthwash is beneficial for people overall.”
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