Diabetes and oral health

If you have diabetes, 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, also called periodontal disease, is an infection of the tissues that hold the teeth in place. 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.

There are often no warning signs of gum disease in its early stages. Symptoms such as pain and loose teeth do not happen until the late stages.

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 
• Bad breath
• 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: Gum disease is often painless. So don't wait for something to hurt before you talk to your 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 experienced by diabetics 
Talk to your dentist about these risks.

Oral infection 
An oral infection is a group of germs that invades an area of your mouth. Some warning signs are:

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. Smoking and wearing dentures can also contribute to these infections. Medicine can treat thrush. But good diabetic control, not smoking and cleaning dentures everyday 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
Some people with diabetes have a dry mouth. This can be caused by some illnesses and medicines such as antihistamines, decongestants, painkillers and diuretics. If not treated, dry mouth can damage your teeth. Your dentist can suggest ways to restore moisture. These include artificial saliva and oral rinses. Sugar-free candy or gum can also stimulate saliva flow.

Recommended home care

You can take steps to keep your mouth healthy:

• Brush your teeth for about three 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 gum tissue stay healthy.

Guidelines for visiting the dentist

Work with your dentist to keep your teeth and mouth healthy:

• 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, ask your dentist if your surgery needs to be postponed.