Diabetes Mellitus is a type of chronic disease which causes a rise in the levels of glucose in the blood. The body utilises glucose, or sugar, as its main source of energy. This glucose is derived from the food we eat. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. In diabetics, the body either does not produce enough insulin or is unable to use its own insulin effectively. This is what causes the blood sugar levels to go up. This high blood sugar can cause damage to many parts of the body like heart, kidneys, eyes, blood vessels and even your teeth and gums.
WHAT SHOULD YOU DO EVERYDAY TO STAY HEALTHY WITH DIABETES
- Follow the healthy eating plan that you and your doctor or dietician have worked out.
- Be active a total of 30 minutes most days. Ask your doctor what activities are best for you.
- Take your medicines as directed.
- Check your blood glucose every day. Each time you check your blood glucose, write the number in your record book.
- Check your feet every day for cuts, blisters, sores, swelling, redness, or sore toenails.
- Brush and floss your teeth every day.
- Control your blood pressure and cholesterol.
- Don’t smoke.
HOW CAN DIABETES AFFECT YOUR TEETH AND GUMS?
Tooth decay and gum diseases are caused by ‘dental plaque’ which is a film of bacteria found in the mouth. Thus anyone can suffer from these diseases. But the high blood sugar in diabetics helps the growth of these bacteria. This causes red, sore and swollen gums which bleed while you brush. In its more serious form, called periodontitis, the gums can pull away from the tooth resulting in an elongated appearance of teeth, bone can be lost, and the teeth may loosen or even fall out.
Emerging research also suggests that the relationship between serious gum disease and diabetes is two-way. Not only are people with diabetes more susceptible to serious gum disease, but serious gum disease may have the potential to affect blood glucose control and contribute to the progression of diabetes.
HOW DO YOU KNOW IF YOU HAVE ORAL PROBLEMS?
If you have one or more of these problems, you may have tooth and gum damage from diabetes:
- red, sore, swollen gums •bleeding gums
- gums pulling away from your teeth so your teeth look long
- loose or sensitive teeth
- increased spaces between teeth
- bad breath
- a bite that feels different
- dentures—false teeth—that do not fit well
HOW CAN GUM DISEASES BE TREATED?
Gingivitis can be controlled and treated with good oral hygiene and regular professional cleaning. More severe forms of periodontal disease can also be treated successfully but may require more extensive treatment. Such treatment might include deep cleaning of the tooth root surfaces below the gums, medications prescribed to take by mouth or placed directly under the gums, and sometimes corrective surgery.
WHAT CAN YOU DO TO KEEP YOUR TEETH AND GUMS HEALTHY?
To help prevent damage to your teeth and gums, take diabetes and dental care seriously:
- Make a commitment to managing 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, after meals and snacks. Use a soft-bristled toothbrush and toothpaste that contains fluoride. Avoid vigorous or harsh scrubbing, which can irritate your gums. Consider using an electric toothbrush, especially if you have arthritis or other problems that make it difficult to brush well. If you wear false teeth, keep them clean.
- Floss your teeth at least once a day. Flossing helps remove plaque between your teeth and under your gumline. If it's hard to manipulate the floss, use a floss holder.
- Schedule regular dental visits.Regular dental checkups and periodontal screenings are important for evaluating overall dental health and for treating dental problems in their initial stages. Your dentist may recommend more frequent evaluations and preventive procedures, such as teeth cleaning, to maintain good oral health.
- 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 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.
ROLE OF A PERIODONTIST
A Periodontist is a dental surgeon who specialises in gum diseases and their treatments. There are large numbers of undiagnosed individuals with diabetes. The oral signs and symptoms of the diabetic patient can be important indicators of the risk of both periodontal disease and future diabetic complications. The present concept is that periodontal treatment can have a positive effect on sugar control in diabetic patients. Patients should be informed that periodontal infection may make it more difficult to control diabetes and conversely, poor diabetic control may increase susceptibility to periodontal infection.
Initiating periodontal care for the diabetic patient should be a foremost concern of physicians as it may make their task easier and reduce insulin requirements. Every diabetic patient should undergo oral examination at least once in 6 months. Periodontal intervention is as important as diabetic medication in the management of diabetic patients. A close cooperation between the Endocrinologist and the Periodontist is vital in the management.