Many diabetics would be surprised to learn there is a connection between oral health and diabetes. With increasing evidence linking them, it’s imperative to educate patients on the need for good oral hygiene. Being proactive and partnering with your patients can help prevent and treat diabetes and related oral diseases.
A growing issue
According to the World Health Organization, the number of people with diabetes is steadily increasing. In 1980, approximately 108 million people suffered with the disease worldwide; by 2014, the number rose to approximately 422 million. Diabetes is a major cause of kidney failure, blindness, lower leg amputation, strokes, and heart attacks. It is also a major cause of gum and mouth disease.
Diabetics suffering from type 1 diabetes experience a relatively quick onset of symptoms. However, experts note that warning signs develop slowly and subtly in type 2 diabetics. The three main symptoms, or the “three P’s,” are:
- Polyphagia: increased appetite
- Polyuria: the need to urinate frequently
- Polydipsia: increased thirst
OnHealth notes that other symptoms of diabetes can include fatigue, unexplained weight loss in spite of appetite and eating habits, headaches, frequent yeast infections, itching skin (especially in the vaginal or groin area), blurred vision, acanthosis (velvety and darkened skin in the areas of the armpits, neck, and groin), numbness and tingling in the feet and hands, impotency, and loss of consciousness.
Left untreated, diabetics begin to experience a decline in oral health. The following symptoms may occur:
- Dry mouth due to less saliva (note that some medications also cause dry mouth)
- Increased susceptibility to cavities due to less saliva
- Delayed healing of wounds
- Gingivitis, including inflamed gums that bleed easily
- Difficulty tasting foods
- Periodontal disease, which destroys gum and mouth tissues
- Thrush, a fungal infection of the mouth
- Sores, ulcers, and infections from reduced saliva
Periodontal disease affects nearly 22% of patients diagnosed with diabetes, making it the most commonly diagnosed dental disease associated with diabetes. As patients age, poorly controlled blood glucose levels increase the risk for gum health issues, including periodontal disease.
There is increasing evidence that diabetes and oral hygiene are reciprocal. The American Diabetes Association explains that research indicates not only are diabetics more susceptible to oral health problems, but those with serious gum disease are also more susceptible to diabetes. Research suggests that properly treating gum disease may even reduce blood sugar levels in diabetics, slowing the advancement of the disease.
An action plan
Poorly controlled blood glucose levels are the first priority in fighting diabetes-related oral health concerns, including gum disease and tooth loss. Patients should be encouraged to monitor sugar levels and manage dietary habits. Brushing and flossing properly are also imperative, and patients should be encouraged to set aside time as a part of their daily routine for this basic care. Patients also need to participate in routine dental exams. Dental professionals can help meet diabetics’ special needs and can be proactive in addressing changes in condition. Patients should be encouraged not to smoke, and those who wear dentures should clean appliances daily to avoid thrush.
Patients with existing dental problems resulting from poor oral hygiene may benefit from dental implants. Dental implants are artificial teeth which are screwed into the jawbone. They provide a natural-looking and permanent solution when one or more teeth need to be replaced.
Oral health for diabetics
With steadily growing numbers of people suffering from diabetes, it’s increasingly important to properly educate patients. Healthcare providers can help patients understand the warning signs of diabetes, explaining the “three P’s” and other symptoms. Watch for signs of oral health decline, and encourage patients to follow an appropriate action plan. Patients and practitioners can partner for better oral health in diabetics, and education is the key.