Heather Lawson -Myers - TOOTH TALK DIABETES IS the name of two metabolic disorders which are generally serious.
The term itself is commonly used as an abbreviation of diabetes mellitus, which is one of the two major forms; the other is diabetes insipidus.
Diabetes insipidus is a disorder that arises from a hormonal imbalance that makes the kidneys overactive or renders them unable to reabsorb the water passed to them from the blood. A person who has the disorder urinates excessively and has a raging thirst and an increased appetite. These are symptoms also of diabetes mellitus, but the two disorders are otherwise unrelated.
ORAL MANIFESTATIONS OF DIABETES
Gum (periodontal) disease
People with diabetes can have tooth and gum problems more often if their blood sugar stays high. High blood sugar can make pre-existing gum disease worse. Person with both type I and type II diabetes are two times more likely to develop periodontal disease that non-diabetics. Smoking compounds the likelihood that you will develop periodontal disease, especially if you have diabetes and are age 45 or older.
Persons with diabetes may experience more frequent cases of periodontal disease and with a greater severity. Diabetes reduces the body's ability to fight infection and as a result, persons with diabetes often experience delayed healing. A cycle can result because persons with diabetes experience delayed healing and a person with large areas of infection will experience uncontrolled diabetes.
Physicians monitor and treat meticulously the large wounds on persons with diabetes because of the way it compromises the patient. In this vein, it is extremely important for diabetics with periodontal disease to be treated and controlled in the dental office. A person with periodontal disease essentially has a source of infection the size of the palm of a hand. An infected area in any other part of the body that size would be a source of concern yet periodontal disease is routinely overlooked.
It is possible for a diabetic patient with an infection to slip into a coma while receiving daily doses of insulin. If your physician is having difficulty controlling your diabetes, consider a visit to the dentist to rule out periodontal disease as a possible reason.
TOOTH DECAY
The high levels of sugar seen in persons with diabetes make teeth more susceptible to tooth decay. Patients should therefore ensure that the mouth is kept meticulously clean using a soft toothbrush, fluoride toothpaste and dental floss. Teeth should be cleaned a minimum of twice daily.
DRY MOUTH (XEROSTOMIA)
Patients with diabetes often experience a reduction of saliva production resulting in a dry mouth. These patients lack the cleansing action of the saliva therefore persons with this condition are susceptible to tooth decay. The constant dryness also causes irritation and inflammation of the soft tissues in the mouth so there is an increase in soreness and ulcer formation. Persons with xerostomia should avoid alcohol and caffeine but drinking lots of fluids, chewing sugarless gum and sucking sugarless candy provide temporary relief.
ORAL FUNGAL INFECTIONS
The most commonly-seen fungal infection in the mouth is thrush (candidiasis). It may be found in the corners of the lips (where upper and lower meet), on tissue covered by a denture, on the tongue or towards the back of the mouth entering the throat. Thrush appears as white or red patches which may become ulcerated (forms sores). Persons may feel painful burning in the areas. Smokers and individuals frequently taking antibiotics are more susceptible to fungal infections.
IMPAIRED TASTE
Some persons with diabetes mellitus complain of a diminished sense of taste. As a result, they often choose sweet-tasting foods.
MAINTAINING A HEALTHY MOUTH
Persons with diabetes must maintain good oral hygiene, brushing at least twice daily with fluoride toothpaste on a soft-bristled brush, and floss at least once daily. The mouth should be cleaned after every meal so, if it is not possible to brush rinse several times with water.
The blood sugar should be closely monitored and every effort should be made to keep it as close to normal as possible. Denture wearers should clean their appliances thoroughly (tooth side and gum side) and regularly. You should never go to sleep with your dentures in the mouth at bedtime. Limit your caffeine and alcohol intake and eliminate smoking.
Visit your dentist regularly for check-ups and advise him/her of any changes in your overall health.
Dr. Heather-Dawn Lawson-Myers, President, Jamaica Dental Association (2003/4).
