Diabetes-related Complications: Diabetes and Oral Health

Diabetes is a prevalent chronic condition that affects millions of people worldwide. Its impact on blood sugar levels, insulin regulation, and overall health has been extensively studied and widely discussed. Yet, in the shadows of these well-known aspects, a critical relationship between diabetes and oral health is often overlooked, leading to consequences that may extend far beyond our teeth and gums.

In this blog, we will explore the connection between diabetes and oral health, exploring the impact of this chronic condition on our mouths and how oral health, in turn, can influence the course of diabetes.

We will also discover the common complications diabetic individuals may face, the science behind these challenges, and practical steps to embrace a holistic approach that nurtures both oral well-being and diabetes management.

Tackling oral health with diabetes

Research reveals that people with type 2 diabetes are almost twice as likely to lose teeth and three times as likely to develop gum disease.

It’s natural to wonder why this happens because the bacteria that cause oral health issues are the same in people with or without diabetes. The key difference is the nature and intensity of your body’s inflammatory response to the bacteria if your sugar levels are consistently high.

This increases the risk of gum inflammations, cavities, and tooth decay, making oral health issues one of the most common diabetes-related conditions.

Common diabetes-related complications in oral health

Gum disease (periodontitis)

• Gum disease begins with uncontrolled bacterial growth in your mouth, usually due to poor dental hygiene.
• It may start as a mild inflammation called gingivitis, which, if left untreated, leads to widespread periodontitis.
• This worsens over time, destroying the tissue surrounding your teeth and causing tooth loss.

What causes gum disease in diabetes?

• Diabetes disrupts your normal immune response, which weakens the action of your white blood cells (your body’s natural defender against infections).
• It also causes your blood vessels to thicken and reduces blood flow which hampers the flow of nutrients to body tissues.
• A combination of these events cooks up the perfect storm- where your body cannot fight infections – leading to more severe gum disease.

Thrush is a fungal infection of the mouth and tongue that can be more common in individuals with diabetes who frequently use antibiotics to treat infections. The fungus Candida albicans flourishes with elevated glucose levels in their saliva.

Symptoms and signs of gum disease

It may be time to visit your dentist and track your blood sugar more diligently, as gum disease is a frequently encountered diabetes-related disease. A few common signs and symptoms of diabetes-related dental issues include:

• Red, swollen, receding gums that are more likely to bleed.
• Loose teeth
• Increased space between your teeth
• Smelly breath, even after cleaning your teeth.

Importance of early diagnosis and interventions

In addition to harming your oral cavity, gum disease can also affect other organs. Periodontitis with uncontrolled bacterial growth and inflammation may lead to vessel blockages and infections like endocarditis, which damages the heart tissue. Aspiration of harmful bacteria from the mouth can lead to lung infections or pneumonia. Therefore, catching gum disease early can prevent a whole host of other health complications.

Tooth decay (cavities)

• If you have uncontrolled diabetes, the high sugar levels in your saliva provide a favorable environment for bacteria to thrive.
• A sticky substance called plaque settles on the surface of your teeth. Bacteria attack the outer protective covering – the tooth enamel- leading to cavities.
• If left untreated, plaque can harden into tartar, making it even harder to clean the teeth properly. As cavities deepen, they become the perfect breeding ground for teeth and gum infections.
• Diabetes also decreases the body’s ability to fight infection and slows healing. A recent study suggests that enamel and dentin, the hard substances in teeth, may be weaker in people with diabetes, which can contribute to tooth decay and loss.

Tips for preventing tooth decay and cavities for people with diabetes

• Clean your teeth with dental floss daily to remove plaque at least once daily.
• After each meal, brush your teeth using a soft-bristled toothbrush.
• Dentures (or false teeth) should be removed and cleaned daily.

Dry mouth (xerostomia)

• It’s important to keep your mouth moist for good oral health. Many of us may occasionally have a dry mouth if the weather is too hot or if we don’t drink enough water. This is due to a lack of saliva or spit.
• Saliva breaks down food, controls bacteria, and strengthens teeth by providing minerals.
• It also helps in rinsing away food particles from teeth and gums, keeping your mouth clean. Without enough saliva, food debris, sugar, and bacteria are often left behind, increasing the risk of cavities and infections.
• Persistent dry mouth or xerostomia, combined with high blood sugar, can lead to serious dental problems.

Symptoms

• Common symptoms of chronic dry mouth include bad breath, chapped lips, loose teeth, mouth sores, a burning sensation in the mouth or throat, a rough tongue, sticky or thick saliva, and difficulties with chewing, swallowing, or speaking.

Easy tips for managing dry mouth

Work closely with your doctor to develop a diabetes management plan that controls your blood sugar levels.

If your dry mouth is due to the side effect of medications, ask your doctor about an alternative or adjustments in dosage.

• Having sugar-free gum or candy can stimulate saliva production.
• Pay attention to the amount of water you consume.
• Use a humidifier at night to increase moisture in the air.
• Avoid coffee and alcoholic beverages as they are dehydrating.
• Avoiding dry and salty foods.
• Chew small bites of your food slowly to encourage saliva flow.

Tips for taking care of your teeth and gums with diabetes

Maintain good oral hygiene

a. Brushing techniques and frequency

• Clean your teeth with toothpaste containing fluoride at least twice daily.
• Use firm yet gentle pressure, brush in a circular motion, and cover all surfaces of your teeth. 
• Interestingly, in Korea, they advocate the 3-3-3 brushing method, which involves brushing three times a day, within three minutes after meals, for at least three minutes each time!

b. Flossing

• Flossing removes food particles, bacteria, and plaque between teeth and along the gum line.

c. Regular dental check-ups

• Visit the dentist at least once yearly (more frequently if advised by your doctor).
• Professional cleanings remove tartar removal which helps keep your teeth clean.

Adopt healthy nutrition habits and lifestyle

a. Balanced diet

• A well-balanced diet containing foods that reduce blood sugar, with low-fat proteins, whole grains, and colourful fruits and vegetables consumed as regularly scheduled meals, helps control blood glucose levels.
• Limit or avoid concentrated sweets.

b. Quit smoking

• All forms of tobacco, including cigarettes, pipes, and smokeless (spit) tobacco, increase the risk of gum disease.
• In addition, smoking weakens your immune system, which makes it harder to fight off gum infections and slows healing.
• It is better to stop smoking and stay away from tobacco use altogether.

Conclusion

By understanding the link between diabetes and oral health, you can take proactive steps to maintain a healthy smile. People with diabetes face unique challenges regarding oral care, suffering from dry mouth, gum disease, and cavities.

However, you can keep diabetes-related diseases and dental issues at bay with proper hygiene, regular dental check-ups, and a balanced lifestyle with foods that reduce blood sugar. Remember, a bright smile is within your reach, even with diabetes!