Dr Vidisha Tayade, MDS
India currently represents 49 percent of the world’s diabetes burden, with an estimated 72 million cases in 2017. Diabetes prevalence has increased by 64 percent across India over the quarter-century, according to a November 2017 report by the Indian Council for Medical Research, Institute for Health Metrics and Evaluation, both research institutes, and the Public Health Foundation of India, an advocacy
In the previous articles you read how diabetics affects oral health and how missing teeth can worsen your diabetics. In this article we shall be discussing what your oral cavity is up against and how its prevention is in your hands!
Effects of diabetes
o Gums: Diabetics are more prone to gum issues like red sore swollen gums. They often experience bleeding gums or gums pulled away from teeth and teeth look long. Teeth become more sensitive and bad breath is experienced. Teeth/ gums don’t feel comfortable. Dentures do not fit well.
o Cavities: Our mouth naturally contains many types of bacteria. When starches and sugars in food and beverages interact with these bacteria, a sticky film known as plaque forms on your teeth. The acids in plaque attack the surfaces of your teeth (enamel and dentin) and can lead to cavities.
In diabetic patients higher the blood sugar level, the greater the supply of sugars and starches — and the more acid wearing away at your teeth.
Also Diabetic patients often experience dryness of mouth/ less saliva in mouth which often is followed by less self-cleansing activity and more cavities.
Dry mouth: Xerostomia occurs when your salivary glands don’t produce sufficient saliva to keep your mouth moist, causing tissues in your mouth to become inflamed and sore. It can make chewing, tasting, and swallowing more difficult, as well as cause difficulty in eating, making it more difficult to control blood sugar. Dry mouth is often leads to bad breath.
Fungal infection: Candida albicans is a fungus that normally lives inside the mouth without causing any problems. But when you have diabetes, deficient saliva in your mouth and extra sugar in your saliva allow the fungus to cause an infection called candidiasis (thrush), which appears as sore white or red areas in your mouth. This fungal infection often spreads on dentures in case of denture wearers.
Burning mouth syndrome: If you feel severe burning and pain in your mouth even though you don’t see any problems causing it, you may have this syndrome.
Oral surgery complications: If you need oral surgery, diabetes— particularly if poorly controlled—can complicate oral surgery. Diabetes retards healing and increases risk of infection. Your blood sugar levels also may be harder to control after oral surgery. Your dentist should work closely with your physician to minimize possible complications
Proper dental care
To help prevent damage to your teeth and gums, take diabetes and dental care seriously:
Manage your diabetes. Monitor your blood sugar level and follow your doctor’s instructions for keeping your blood sugar level within your target range. The better you control your blood sugar level, the less likely you are to develop gingivitis and other dental problems.
Brush your teeth at least twice a day. Brush in the morning, at night and, ideally either brushing/ rinsing after meals and snack. Use a soft-bristled toothbrush and toothpaste that contains fluoride. Avoid vigorous or harsh brushing, which can irritate your gums. Get a new toothbrush at least every three months. Consult your dentist to know the right brushing technique.
Floss your teeth at least once a day. Flossing helps remove plaque between your teeth and under your gumline. If you have trouble getting floss through your teeth, use the waxed variety. If it’s hard to manipulate the floss, use a floss holder.
Use water/air flosser: If you already have multiple false teeth or bridges in mouth which may be teeth or implant supported than new generation automatic flosser is a must. These flossers reach out all the surfaces of the natural and false teeth which are difficult to clean and help in maintaining good oral hygiene.
Mouth wash: Always use non-alcoholic (prevents dryness of mouth) and sugar free mouth wash. Your dentist can guide you with the right one.
Make sure your dentist knows you have diabetes. Every time you visit your dentist, remind him or her that you have diabetes. Make sure your dentist has contact information for your doctor who helps you manage your diabetes.
Look for early signs of gum disease. Report any signs of gum disease — including redness, swelling and bleeding gums — to your dentist. Also mention any other signs and symptoms, such as dry mouth, loose teeth, bad breath or mouth pain.
Don’t smoke. Smoking increases the risk of serious diabetes complications, including gum disease. If you smoke, ask your doctor about options to help you quit.
Dentures: If you wear dentures, remove and clean them after every meal & daily clean them beforestoring in air tight container at night. Do not sleep in them. If you see discolouration, surface irregularity or growth or smelly denture consult your dentist immediately.
Schedule regular dental visits. Visit your dentist at least twice a year for professional cleanings and checkups
Managing diabetes is a lifelong commitment, and that includes proper dental care. Your efforts will be rewarded with a lifetime of healthy teeth and gums.