Diabetes and oral health

People with diabetes face a greater risk of gum problems. The best way to protect against gum disease is to keep good control over your blood sugar. People who don't control their blood sugar well get gum disease more often. And they get it more severely.

How gum disease develops

Gum disease is an infection of the tissues that hold the teeth in place. It's also called periodontal disease. Plaque is a film of germs that builds up and hardens under the gums. This causes the gums to become inflamed. The infection may lead to the loss of bone around the teeth and to tooth loss.

Warning signs of gum disease

Visit your dentist if you have any of the following warning signs:

• Bleeding gums when you brush or floss
• Red, swollen or tender gums
• Gums that have pulled away from the teeth
• Pus between the teeth and gums
• Permanent teeth that are loose or moving away from each other
• Changes in the way your teeth fit when you bite
• Changes in the fit of partial dentures

Remember: There are often no warning signs of early gum disease. Symptoms such as pain and loose teeth do not happen until the late stages. So be sure to have regular checkups. Don't wait for something to hurt before you go to the dentist.
 
Treating gum disease

Dentists treat gum disease with scaling and root planing. This removes the hard plaque, even below the gum line. Gum surgery may be needed if gum disease is far along. Treatment will only be successful if you brush and floss regularly to keep the plaque from building up again.
 
Other mouth problems diabetics can have 

Fungal infections
If you have diabetes you are more prone to fungal infections, such as thrush. Fungus thrives on the high sugar levels in saliva. Medicine can treat thrush. But good diabetic control, not smoking and cleaning dentures every day can prevent thrush.

Poor healing
If your diabetes is not under tight control, you will heal more slowly. You also increase your chance of infection. Increase your chances for a better recovery. Keep your blood glucose under control before, during and after any scheduled dental procedure.

Dry mouth
Diabetes is one of the illnesses that can cause dry mouth. You need enough saliva to wash away food and neutralize the acids produced by plaque. Your dentist can suggest ways to restore moisture and protect your teeth.
 

Taking care of your teeth and gums

You can take important steps at home to keep your mouth healthy:

• Brush your teeth for about two  minutes each time you brush. This helps to make sure you're cleaning all your teeth.
• Brush at least twice a day.
• Use a toothbrush with soft bristles.
• Floss once a day. Flossing cleans away plaque and bits of food from between your teeth and below the gum line. It gets to places your brush can't reach.
• Ask your dentist if you should have a fluoride rinse to help prevent decay.
• If you wear dentures, clean them every day. Be sure to remove stains and plaque that may build up and irritate your gums. Take your dentures out when you sleep to help your gums  stay healthy.

Diabetes can affect your dental treatment as well as the health of your mouth. Work with your dentist on a treatment plan to meet your needs:

• Visit your dentist regularly.
• Tell your dentist you have diabetes.
• Let the dentist know if you have problems with infection or trouble keeping your blood glucose under control.
• Eat before you see your dentist. The best time for dental work is when your blood glucose level is on the high side and your insulin action is low.
• Take your normal medicines before your dental visit. (Unless your dentist or doctor tells you differently.)
• Follow your normal meal plan after dental work. If you can't chew well, plan ahead to make sure you meet your nutritional needs.
• If your blood glucose is poorly controlled and you are scheduled to have dental surgery, let your dentist know. Ask if your surgery needs to be postponed.