Diabetes Mouth Infections
Oral hygiene may seem like no big deal, or maybe even a nuisance. There are so many other things to worry about if you have diabetes. But the truth is, if you have diabetes, it is critical to take good care of your mouth, teeth and gums. People with diabetes are more prone to gum disease and infections. Infections can undermine your efforts to control your blood glucose levels and lead to emergency situations. And, pain in your mouth could have hidden consequence.
Any time you have pain or discomfort in your mouth, you may not be able to eat. That is one of the worst things that could happen to someone with diabetes, because maintaining good blood glucose control depends on carefully balancing your food intake with available insulin. Therefore, it is critical to maintain good oral health by taking preventive measures to keep your mouth, teeth and gums in top form.
Diabetes can affect your oral health in several ways. If you have diabetes you are more likely to have high blood glucose levels, and this can affect your circulation. This means that the small blood vessels that supply your mouth with oxygen and nutrients are easily damaged. As a result, you are more likely to develop gum disease, and gum problems in someone with diabetes are slower to heal than in someone without diabetes.
If you have diabetes you are more likely to develop infections and also have a harder time fighting off infections. If you have a deep cavity, for example, your white blood cells are less capable of fighting off invading bacterial than those of people without diabetes. As a result, you are more likely to develop abscesses and other infections. This may be because your probably have higher levels of glucose in your saliva. This glucose feeds the bacteria in your mouth that can cause infection and damage your gums.
If you have diabetes, you are at a high risk for autonomic neuropathy. When the nerves that control the production of saliva in your mouth are damaged, you could develop a condition known as ‘dry mouth’ or xerostomia. Without a good supply of saliva, you are at an increased risk for cavities and infection of the mouth.
Fortunately, you can minimize the risk of infection, gum disease and other problems of the mouth by practicing good oral hygiene and keeping your blood glucose levels under control.
DIABETES MOUTH INFECTIONS
DIABETES PERIODONTAL DISEASE
Periodontal disease is also known as gum disease. Your teeth are anchored in your mouth by bone, and your gums provide a soft covering of the juncture between tooth and bone. Bacteria can grow in the space between your gums and teeth. When this gets out of control, you have gum disease.
In its earliest stage, referred to as gingivitis, your teeth become covered by a thin film known as plaque, which is rich in bacteria. As the disease progresses to periodontitis, a harder material known as tartar also adheres to the teeth and gathers between the teeth and gums. Tartar, also know and calculus, is equally rich in bacteria. As gum disease progresses, the gum recede and the underlying bone erodes away. Without treatment, the loss of your teeth and further erosion of the gums and bone is inevitable. Fortunately, the process can be stopped at any stage with proper treatment.
DIABETES PERIODONTAL DISEASE SYMPTOMS
Symptoms of gingivitis, the earliest stage of gum disease, include redness and swelling of the gums. You may find that your gums bleed easily, especially when you are flossing or even brushing your teeth. Plaque and tartar are visible along the surface of the teeth and below the gum line. As gum disease progresses, the gum line recedes, exposing the roots of your teeth. As the gum line recedes further, the bone holding your teeth in place also begins to erode, further exposing the roots. Eventually the bone loss will be so great that your teeth will become loose and may fall out.
What You Should Do
Gum disease in itself is not life-threatening and does not require emergency attention. However, as soon as you see any signs of gum disease, including redness of the gums, or if you notice that your gum bleed easily, schedule an appointment with your dentist right away. The earlier you seek treatment, the less likely you are to lose your teeth. Once your gum and bones recede, they will not grow back again. However, you can prevent further loss of gum and bone by proper treatment.
DIABETES PERIODONTAL DISEASE TREATMENT
If you haven’t seen a dentist in a while, you will be given a thorough examination on your first visit. Your dentist will first examine your gums and teeth to look for signs of gum disease. Your dentist may also take X rays of your teeth. This will reveal whether any bone loss has taken place. Your dentist may also measure the depth of the pocket that surround each tooth to further evaluate the extent of gum disease. Your teeth will also be examined for any signs of decay, broken, chipped or cracked teeth, defective crowns or missing or misfit fillings.
If your gum disease is in its early stages, the treatment can be as simple as routine dental cleanings every 3 to 6 months. During these visits, your dentists or dental hygienist will remove the plaque and tartar with dental instruments. If the plaque and tartar buildup is more substantial, your dentist may recommend a scaling and root planning treatment. This deep-cleaning treatment will probably involve several trips to the dentist and will require a local anesthetic. Once you have this procedure performed, your dentist may recommend more frequent follow-up visits than the standard 6-month interval.
When gum disease is more severe, it may be more difficult to conduct a deep cleaning of the gums and teeth. This is because there is not enough bone to support the teeth. In this case your dentist may refer you to a gum specialist, a periodontist. Depending on the state of your gums, the periodontist may perform gum surgery. The goal of this type of surgery is to reshape the bone and reposition the gums to make your teeth and gum easier to clean. Without this sort of reshaping, the pockets between your teeth and gums can become so deep and accumulate so much plaque and tartar that they are impossible to clean. This leads to further gum recession and bone loss that inevitably leads to tooth loss. The goal here is to stop the cycle and allow you to preserve your gums, bone and teeth.
DIABETES PERIODONTAL DISEASE PREVENTION
The simplest way to prevent gum disease is to keep plaque and tartar from accumulating on your teeth. Although maintaining good oral health is more difficult for people with diabetes, it is not impossible. Once you have an initial, thorough cleaning, your dentist may recommend that you brush your teeth after every mean and before bedtime, and floss daily. If you have bridgework that makes it difficult to get between your teeth, your dentist may be able to give you an instrument to aid cleaning. Electric toothbrushes may help if you have a hard time moving your hands to brush your teeth manually. You may also consider using dental care products at home aimed to kill plaque and bacteria and prevent tartar buildup. And don’t forget to visit your dentist on a regular basis: every 3 to 6 months for a thorough cleaning.
DIABETES DRY MOUTH
As its name suggests, dry mouth is a condition characterized by a lack of saliva. It is thought to be caused by autonomic neuropathy. Saliva performs several functions in your mouth. It helps you digest your food, keeps your mouth lubricated and helps keep your mouth clean. When you don’t have enough saliva, the condition can be more than annoying. It can become difficult to speak and eat and it can give your mouth a bad taste and odor. Also, if you have dry mouth, you are more likely to get dental cavities
DIABETES DRY MOUTH SYMPTOMS
Symptoms of dry mouth include a lack of saliva, a bad taste and odor in the mouth, and difficulty swallowing, eating and talking.
What You Should Do
If you have symptoms of dry mouth, talk to your dentist. She can prescribe gel or rinses that have a high fluoride content. These will help to remineralize or fill in holes or small cavities. However, these products should only be used under the advice of your dentist. Your dentist may also recommend artificial saliva. This can be sipped and swished around your mouth to help you eat or speak better.
There are other techniques you can use yourself. Try chewing gum or sucking on candies or mint (sugarless, of course). Chewing gum and candy will stimulate the flow of saliva. A bonus of chewing sugarless gum is that it decreases cavity formation. Water will also help keep your mouth moist. Taking frequent small sips throughout the day or sucking on ice chips may work well.
DIABETES DRY MOUTH PREVENTION
Because dry mouth is caused by neuropathy, the best way to prevent it is to control your blood glucose levels over the long term, which reduces your risk of neuropathy
DIABETES THRUSH
Thrush is a type of infection in the mouth caused by yeast-like fungus known scientifically as Candida albicans. If left unchecked, thrush can cause your blood glucose levels to swing. It occurs more frequently in people with diabetes, because Candida microorganism thrives on the extra glucose found in the saliva of people with diabetes.
DIABETES THRUSH SYMPTOMS
Symptoms of thrush include the appearance of creamy white patches or red areas of irritation in the mouth. These patches can be scraped off easily with a finger or a spoon. Your mouth may feel sore or you may feel a burning sensation. If you wear dentures, they may become impossible to wear.
What You Should Do
Notify your doctor or dentist right away if you experience any of these symptoms. Like any infection, thrush can upset your blood glucose control. Thrush can be easily treated, but the sooner you begin treatment, the easier it is to get rid of.
DIABETES THRUSH TREATMENT
Thrush can be treated by prescription antifungal drugs available in several forms. You can take a pill that kills the fungus systematically. Or you can use a medicated rinse that you swish around in your mouth and spit out. A lozenge that dissolves slowly in your mouth is also available.
DIABETES DENTAL TREATMENT
A trip to the dentist can make anyone anxious and uncomfortable. But if you have diabetes, you may have special concerns when you visit the dentist, whether for extensive treatment or routine care. If your diabetes is well controlled, routine care should pose no more problems for you than for a person without diabetes. But if your diabetes is not well controlled, your dental visits may be more challenging.
What You Should Do
If your diabetes is well controlled, you may only have to follow a few extra precautions for routine dental visits. These include routine exam, cleaning, X rays and simple fillings. If you require a local anesthetic, you may need to avoid the use of anything with epinephrine. This is especially true if you have had diabetes for a long time, have any evidence of neuropathy, or have any history of heart problems.
Epinephrine can cause your heart to beat rapidly, a condition known as tachycardia, and should be avoided in many patients.
After you go to the dentist, depending on what procedures you have performed, you may find it difficult to eat or chew. This may interfere with your blood glucose control if you cannot follow your regular eating plan. If you take insulin or an oral medication, try to schedule your visits for the mid-morning. This will make it easier for you to take your morning medication and eat a normal breakfast.
Try to schedule it so that there will be ample time for any anesthetic to wear off before your next meal is due. Monitor your blood glucose level before your visit, and tell your dentist what your blood glucose level is. You may want to ask your dentist to use a shorter-acting anesthetic so you don’t have to skip or postpone a meal. You may want to try taking a liquid meal while you are recovering from the anesthetic or the procedure itself.
If your diabetes is well controlled, you can probably undergo more extensive treatments without much adjustment. Make sure your dentist consults with your doctor to see if any special precautions should be followed. For example, your doctor may want you to take an antibiotic before and after surgery, to prevent any bacterial infection from developing. Also, monitor your blood glucose levels before and after any dental work. Stress, anxiety, pain and infection can all affect your blood glucose level.
If your diabetes is not well controlled, you may need to take extra precautions. Make sure your dentist consults with your doctor, even for the most routine visits. If you are not under the care of a doctor, you should not have any major dental work done without first having an overall assessment of your health.
Report any heart problems or other complications of diabetes to your dentist before having anything done. People with heart valve abnormalities, for example, should take a preventive dose of antibiotic before even the most routine care, including cleaning.
Prevention
The best way to prevent any problems with your dental visits is to make sure your dentist knows you have diabetes, ask your dentist to consult with your doctor before any dental treatment, and try to time your visits so they will not interfere with your blood glucose control. Realize that even the mildest amount of stress or anxiety can affect blood glucose levels, so monitor your blood glucose both before and after your visit.
Sources and References
The Diabetes Problem Solver—Quick Answers to Your Questions About Treatment and Self-Care by Nancy Touchette
Diabetes as a potential risk for periodontitis: association studies by Robert Genco and Wenche Borgnakke
Xerostomia, Hyposalivation, and Salivary Flow in Diabetes Patients by Lorenzo de Arriba, Julia Serrano et al
Diabetes and oral health: an overview by Jonathan Ship
Oral candidiasis by A Akpan and R Morgan
Rich Health Editorial Team
Rich Health Editorial Team is made up of medical practitioners and experienced writers who provide information for dealing with health issues in a simple and easy-to-understand manner
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