I Have Diabetes.  Why is My Dentist Concerned?

Diabetes affects millions of Americans today, and millions more are pre-diabetic.  In this serious health condition, the body is no longer able to regulate blood sugar levels.

Diabetes affects the entire body, leading to serious consequences if left uncontrolled.  This article will focus on how it affects the health of the mouth.

The Effects of Diabetes on the Mouth

Dentists often surprise diabetic patients with comments or concerns about the health of their teeth and gums.  In some cases, the dentist or dental hygienist is the first person to notice signs of diabetes, recommending the patient see his or her medical doctor for evaluation.  This is because untreated diabetes causes changes leaves visible evidence in the mouth.

Lack of Blood Flow to the Gums

One of the consequences of untreated diabetes is a loss of blood flow to the extremities of the body.  This is the cause of the common need for amputation of toes in diabetic patients, and the source of their high risk for losing their eyesight (diabetic retinopathy).  What most diabetic patients do not realize is that the gum tissues in the mouth are also an extremity.

This lack of blood flow to the gums causes a variety of problems.  The gums may appear pale pink, and they will not bleed easily.  Without good blood flow, diabetic patients do not exhibit the “normal” signs of gum disease.

Dry Mouth

Diabetic patients commonly suffer from a dry mouth.  Dry mouth is a dangerous condition that can wreak havoc on the health of the teeth and gums.  Dry mouth increases the risk for both cavities and gum disease by allowing more dental plaque to accumulate on the teeth.  The type of plaque that builds up in a dry mouth is also more difficult to remove with brushing and flossing.  It has a stickier consistency.

Dry mouth causes bad breath and a high risk for mouth sores and ulcers.

The Two-Way Link between Diabetes and Gum Disease

Research has shown for decades that the health of the mouth affects various medical conditions, like heart disease, stroke, and diabetes.  What is interesting about diabetes is that it has a connection with gum disease that goes both ways.  Put simply, diabetes makes gum disease worse, and active gum disease makes diabetes worse.

Patients with untreated or uncontrolled diabetes typically have rapidly worsening gum disease, losing the bone and gum attachment to their teeth despite good oral hygiene.

Those with active gum disease and its accompanying high levels of bacteria (high bacterial load) have more difficulty lowering their blood sugar levels.

This means that if you have both diabetes and gum disease, you must get them both under control in order to be successful at treating either one of them.  We hear patients make statements like, “I’ll have my gum treatments once I get my blood sugar under control” or “I’ll work on my sugar levels after I get my dental work done”.  Unfortunately, to achieve any success, you have to get them both under control at the same time.

Impaired Wound Healing

Another effect of diabetes on the mouth is its effect on wound healing.  When someone has uncontrolled blood sugar, they have a poor ability to heal from injuries or surgeries.  This is due to the lack of healthy blood flow to the mouth.

When a diabetic patient undergoes tooth extractions, dental implant placement, or other oral surgical procedures, it often takes twice as long to heal as a patient with healthy blood sugar levels.  Diabetic patients have a much higher rate of dental implant failure, and they experience more post-operative complications after all oral surgeries.

In order to improve your ability to heal from an injury or surgery (and this applies to the whole body, not just the mouth), you should work to control the A1C level as strictly as possible for at least two weeks before and four weeks after the procedure.  This improves the blood flow to the surgery site and enables your body to heal successfully.

More Questions about Diabetes and Oral Health?

Call Timberlake Dental today at 940-382-1750 to schedule a consultation with Dr. Chowning.  He can answer all of your questions about how diabetes affects the mouth.  He can also assess your current situation and help you maintain great oral health for a lifetime.

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