Why your dentist needs to know if you have diabetes

Why your dentist needs to know if you have diabetes

When you think about health professionals that can help manage chronic diseases, your dentist is probably not high on the list. However, if you look at diabetes as an example, evidence indicates that your oral health professional should be an important player on your health care team, and not just to look after your mouth.

In fact, an oral health professional can often help diabetics to improve their long-term general health outcomes, including managing their blood sugar levels. 

The prevalence of diabetes in Australia is of significant concern. 1.7 million Australians have diabetes, with more than 100,000 developing the disease in the past year alone.[1] While in itself, managing diabetes is a never-ending juggling act, managing the risk of the many health issues associated with diabetes can become overwhelming. These include (but are not limited to) cardiovascular disease, nerve and kidney damage, skin conditions, and oral health issues.

There are a number of oral health issues that can impact people with diabetes. These include gum disease, gum abscesses (infection of the gums), dry mouth, tooth decay and mouth ulcers, to name a few. Let’s look at why diabetics are more prone to developing these issues.

Potential reasons why diabetics are prone to specific oral health issues can include the use of certain medications and the fact that foods and beverages used to treat hypos (short for hypoglycaemia – when a person’s blood sugar level drops too low) are high in sugar and can lead to tooth decay. However, perhaps the main culprit is poorly managed blood sugar levels. 

Poor glucose control can result in damage to blood vessels, making infections of the soft tissue (gum) and bone that supports the teeth more likely.  When blood sugar levels are not well-managed there is heightened risk of infections.  Other oral health issues like dry mouth can also occur when blood sugar levels are elevated.[2] [3]

We know that diabetic management and oral health management is a two-way street. Poorly controlled diabetes can affect the mouth, but you might be surprised by the degree to which poorly managed oral health issues can negatively impact diabetic control.

Evidence is now indicating that severe periodontal disease (periodontal refers to structures around the teeth including gums, ligaments and bone) can actually increase blood sugar levels.  Evidence also leads us to believe that when diabetics with poor glucose control undergo periodontal treatment, it can actually help them to improve blood glucose levels long-term.  In turn, this can help to reduce the risk of developing other common diabetic complications, including heart and kidney disease.[4]

Now that we know the true benefits of good oral health, there are five important steps that can help diabetics achieve a healthy mouth.

  1. Practice good oral hygiene: Brush your teeth and gums twice a day with a fluoride toothpaste.  If you treat a hypoglycaemic event by consuming a high-sugar food or beverage, be sure to wait 30 to 60 minutes before brushing your teeth.  This allows teeth time to restore their mineral content and avoid the risk of erosion.
  2. Have regular oral health check-ups: If you are a newly diagnosed diabetic, establish a regular oral health examination routine. Depending on your situation, your oral health professional will advise how often you will need to attend.  Even if you have dentures, you should still visit an oral health professional because you are still at risk of gum disease.
  3. Tell your oral health professional that you have diabetes and be sure to let them know your blood sugar reading and what medications you are taking. Also let your oral health professional know which health professional (eg your GP) is helping to manage your diabetes so that, with your permission, they can share relevant information about your health management.
  4. Manage your diabetes and understand the link to oral health: Ensure your blood sugar levels remain within your target range.
  5. If you smoke, stop!

The mouth is connected to the body and quite often, the mouth is one of the first sites to indicate that there is an underlying health condition.  For example, there is a very good chance that people experiencing recurring gum abscesses could have undiagnosed type 2 diabetes.

This is why, when it comes to managing chronic diseases like diabetes, dentists are increasingly significant players in the management of a patient’s whole health plan, not just their oral health. 

By helping to control oral inflammation and infection, an oral health professional can assist a diabetic patient in maintaining good blood sugar levels.  Oral health professionals can also help diabetic control by promoting healthy lifestyle choices to maintain good blood sugar levels.  In the future, it is highly likely that dentists and periodontists will even monitor blood sugar levels at dental appointments. 

If you are diabetic, or live with any chronic illness, make an appointment with your dentist and ask about how it might be impacting your oral health, and how your oral health might be impacting your general health.

 


The Oral Health Advisory Panel (OHAP), is a group of independent healthcare professionals with the aim of raising awareness of the importance of good oral health and its impact on general wellness.  The Panel aims to take oral health beyond the dental clinic.

Follow the Oral Health Advisory Panel via twitter @OHAPanel to stay up to date with practical advice on good oral health habits.


 

 

[1] Diabetes Australia – www.diabetesaustralia.com.au/diabetes-in-australia  Accessed 31 May 2018
[2] Diabetes Australia – www.diabetesaustralia.com.au/news/11085?type=articles Accessed 31 May 2018
[3] www.nature.com/articles/sj.bdj.2017.745 Accessed 31 May 2018
[4] www.nature.com/articles/sj.bdj.2017.745 Accessed 31 May 2018

Share
Mark Bartold
Mark Bartold

Founding Member Oral Health Advisory Panel, Colgate Australian Clinical Dental Research Centre, University of Adelaide, specialising in periodontics.

Read More