[ Diabetes Type 1 ]

Diabetes and Dentistry | Diabetes Health

What Is It? There will be no charge for changing your appointment provided that we are given 24 hours notice. Research shows the relationship between serious gum disease (periodontitis) and diabetes can run both ways. When the body cannot… As discussed in earlier posts, in order to manage your diabetes successfully it’s all about control. This inflammation shows up in many places, including your gums. 8.

Overall, 56.8 percent of dentate adults with diabetes reported having a dental care visit in the preceding year compared with 64.7 percent for those without diabetes. Contact us today on 02075639980 to learn more about how our consultations work. Study Included More Than 1,000 Patients The field trial by Dr. Diabetics are more susceptible to mouth infections, especially periodontal (gum) disease, which can damage the gum and bone that hold teeth in place. Systemic antibiotic therapy or topical antimicrobial therapies are accepted treatment modalities for aggressive treatment of oral infections. Dr. Both plaque and tartar make the gums vulnerable to infection.

If an infection enters the gums it is referred to as gingivitis, the first stage of periodontitis. Bacteria that collect and breed at the gum line and the groove between the gum and the tooth cause the gums to redden, swell and bleed. This response is normal but can also lead to periodontitis. Gums affected by gingivitis often bleed and are sensitive, but not always. Other signs include swollen gums, loose teeth, a bad taste in the mouth and persistent bad breath. BG control and good oral hygiene seems to be the key to avoiding most dental complications. Everyone is at risk of developing periodontal disease, but all people with diabetes, regardless of age or type of diabetes, are more susceptible.

There are several reasons for this. It also makes healing more difficult once an infection sets in. Just like diabetics with poor BG control have a hard time healing wounds and infections on their feet, their bodies have a hard time fighting infections and healing wounds in the mouth. Since this condition can… Inflammation and infection affect BG control no matter where they occur. But the mouth is often overlooked as most doctors do not look in the mouth. Once an infection takes root a vicious cycle ensues making metabolic and infection control a struggle.

This cycle can have drastic consequences. If oral infections get out of control they can lead to BG control problems serious enough to land a person with diabetes in the hospital, to say nothing of the damage to the teeth and gums. Strauss and colleagues, A1C levels obtained using gingival crevicular blood samples were highly correlated with finger-stick blood A1C levels. Authors of a study cited in September’s 1997’s Practical Diabetology concluded that when an infection is rampant, patients with diabetes often have increased insulin requirements. If periodontal disease is treated and gingival inflammation is eliminated, these insulin needs often decrease. General dentists and hygienists manage 90% of patients with periodontitis today, but many do not receive enough educational training in the treatment of the condition — affecting gums and other supporting tissues around the teeth — nor its close ties with diabetes. Neuropathy and certain medications may be the cause of reduced salivary flow.

Finney says that saliva is important to wash residue off teeth and gums and prevent tooth and gum disease. Ask your dentist about products that moisten the mouth or increase saliva. “Retinopathy and dental problems are closely related. If you look at a population that is having eye problems, that same population is likely to have dental problems. If a person is diagnosed with retinopathy, they should make sure that their mouth is being examined and the gums are healthy. Conversely, if there is serious gum disease there may be other diabetic complications taking place in the body,” says Finney. Problems that begin elsewhere in the body should also provide clues for health care professionals.

The presence of microalbuminuria and neuropathy are signals to check the mouth for potential complications. As with all diabetic complications, an ounce of prevention is worth its weight in gold. By far the most important step that can be taken is to brush and floss regularly. It is advisable to discuss proper brushing and flossing techniques with your dental team. Some of the fundamentals might surprise you. For example, it is recommended that you brush for a minimum of three minutes, which, when put into practice, is longer than one might imagine. Prevention also includes making and keeping the often dreaded dental appointment.

Finney suggests seeing the dentist twice a year, or as often as necessary. If you are avoiding the dentist due to fear and or loathing, see below for some strategies to make it a little easier to deal with. And it is the duty of dental practitioners to understand the importance of accurate diagnosis and treatment of periodontal disease, as we know that a strong correlation exists between periodontal disease and diabetes. Test your BGs before you go to the dentist and test them while you are at the dentists office. Make sure to stick to your regular insulin and/or oral medication schedule to avoid BG problems. It is also important to discuss your diabetes with your dental team. If an infection is already present, it must be treated before any significant procedures can be attempted.

Once diabetes is under good control, oral surgery can be performed without complication. Since periodontal disease can lead to tooth loss, many patients are fitted for dentures. Patients wearing complete dentures should see the dentist once a year to examine all soft tissue areas. Partial dentures require attention to hygiene just like real teeth. They need to be removed and cleaned daily. Dentures may also be ill-fitting and uncomfortable. This is because the gums of people with diabetes may be especially sensitive.

This in turn makes eating, and maintaining good health and proper BG control more difficult. Dental therapy for people with diabetes does not have an established criteria, although dental offices record medical conditions such as diabetes they may not be prepared for an emergency resulting from diabetes. It is important to discuss your diabetes and possible low and high blood sugar scenarios with your dental team. According to Finney, the dental team needs to know if their patients take oral agents or insulin because that means special precautions must be taken. He advocates that dentists caring for patients with diabetes have a calibrated glucose meter, glucose tablets or fruit juice, and a glucagon kit available. They should also be familiar with the common signs of hypoglycemia such as loss of coordination, blurry vision, palpitations, rapid heart rate, sweating and shaking. He also suggests finding out if a patient with diabetes has hypoglycemic unawareness, a condition in which they experience few if any signs and symptoms of low blood sugars.

Severe hyperglycemia may occur as well, but less frequently. Acetone breath and dehydration, dry mucous membranes and changes in mental status are signs that blood glucose is too high and dental procedures should be postponed. Organizations such as the National Oral Health Information Clearinghouse can offer valuable information on dental health and diabetes. They can be contacted at 1 NOHIC Way, Bethesda, MD, 20892-3500 or call 301-402-7364. “The key thing to remember is that diabetes can cause additional problems so those with diabetes need to take additional care to keep their teeth and gums healthy,” says Finney.

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