Diabetes & Dental Health

How Diabetes Affects Oral Health

Millions of Americans suffer from diabetes, and millions more are pre-diabetic.  This disease, which affects the body’s ability to regulate and control the amount of sugar in the blood, causes damage to many different areas of the body.  Many people are aware that diabetic patients are at risk for losing their eyesight or requiring amputations of toes or legs.  Diabetes also has disastrous effects on the mouth.

Diabetes and Cavities

People with diabetes have a high risk for cavities.  Not only does high blood sugar cause dry mouth; many of the medications used to treat diabetes also have dry mouth as a side effect.  Having a dry mouth greatly increases the risk for developing new cavities.

Saliva is the body’s best defense against cavities.  It works to neutralize the acid produced by cavity-causing bacteria and loosen dental plaque.  When you do not have enough saliva, the mouth becomes a more acidic environment, and dental plaque is stickier and harder to remove from the teeth.  Patients with a dry mouth have a tendency to develop cavities between the teeth and near the gums because that is where plaque accumulates.

The acidic environment allows bacteria to weaken and soften enamel much faster.  The fact that plaque is harder to remove means that the bacteria stay in contact with your teeth for longer.  Both of these situations factor together to give people with diabetes a very high risk for cavities.

Diabetes and Gum Disease

The dry mouth that leads to a higher cavity risk also causes a higher risk for gum disease.  That sticky plaque also contains the dangerous bacteria that cause gum disease.  Gum disease is both an infectious and an inflammatory disease.  It is infectious because it begins with an overgrowth of certain bacteria in the gums.  This bacteria, which resides in dental plaque, produces toxins, and these toxins cause an inflammatory response by the body.

The purpose of the inflammatory response is to bring healing cells to the site of the infection.  The problem is that when you ignore gum disease, the acute inflammation (which is good) becomes chronic inflammation (which is bad).  Chronic inflammation is destructive in nature and causes breakdown of the connection between the teeth and their surrounding bone and gums.

One of the dangers of diabetes is the loss of blood supply to extremities, and the gums are an extremity.  Without the proper blood supply, the gums cannot fight the bacteria and toxins present in the dental plaque.  This lack of blood supply also affects the nerves giving sensation to these areas (called neuropathy), so most people will not feel any symptoms in their gums.  A diabetic person can have devastating gum and bone loss around the teeth and be completely unaware of the problem.

Gum disease progresses very rapidly in patients with diabetes, and it requires diligent and consistent treatment.  Basically, people with diabetes have to work much harder to fight gum disease than someone without diabetes does.

Diabetes and Healing from Oral Surgery

Diabetes causes delayed healing of wounds and surgical sites all over the body, and the mouth is no exception.  The reason for this is the lack of good blood supply to the extremities.  In order for gum tissues to close over a tooth extraction or periodontal surgery, you must have a healthy blood supply.  For the jawbone to connect with a dental implant, good blood flow is a must.

Because diabetic patients do not have good blood flow to the gums, they can expect a longer healing period from any type of oral surgery.  They also have a higher risk for post-operative infections because they lack the good blood flow that the body needs in order to fight off bacteria.  A diabetic person is much more likely to have a dental implant fail.

This does not mean that people with diabetes should never have oral surgery.  In some cases, it is impossible to avoid surgical procedures.  It does mean that you must understand two very important things going into any type of surgery:

  1. You will likely experience a longer healing period than others with a higher risk for post-operative complications.
  2. You can influence the healing period and likelihood of complications by controlling your blood sugar!

You do have some control over the complications of diabetes, and it all depends on how well you control your blood sugar.  Sticking to a strict diet and medication regimen lowers your risk for post-operative complications and improves your body’s ability to heal!  Work with your medical doctor to gain strict control over blood sugar before any surgery takes place.

The Effect of Oral Health on Diabetes

The link between diabetes and oral health is actually a two-way street.  Not only does diabetes have a negative effect on the mouth; the mouth can have a negative effect on diabetes when it is unhealthy.  The bacterial load and the chronic inflammation of periodontal disease actually make it harder to keep your blood sugar under control.  Patients with untreated gum disease often have uncontrollable high blood sugar.  It can become a vicious cycle: high blood sugar allows gum disease to worsen, and as gum disease worsens and bacteria increase, the blood sugar becomes harder to control.

By undergoing periodontal therapy for gum disease, patients are breaking this vicious cycle and are actually able to lower their blood sugar.  By working with their doctors to control blood sugar, diabetic patients improve the success of gum treatments.  Because this link goes both ways, it is very important for people with diabetes to understand that you cannot focus on just one of these diseases at a time.  You must treat both diabetes and gum disease in order to get the best outcome!

Do You or One of Your Loved Ones Have Diabetes?

If so, it is important for you to see your dentist for consistent oral health care.  Call your nearest Premier Dental of Ohio location today to schedule a visit with one of our wonderful dentists.  Our goal is for every single one of our patient, including those with diabetes, to have a completely healthy mouth.