According to the CDC, some 38 million Americans are currently living diabetes. 1 in 5 of those Americans don’t even know that’s the case. That amounts to 11.3% of our population that struggles with this wearying disease. Diabetes may increase a person’s risk of fatigue, infection, blurry vision, or numbness in hands or feet. When left untreated, it may result in heart disease, nerve or kidney damage, or even strokes.

The more we learn about medicine, the more we understand that your body is an interconnected entity. What affects one part—like the blood sugar—is likely to have a ripple effect, and that clearly holds true for diabetes. The first symptom you recall when you think of diabetes might be fatigue or risk of strokes. But the fact is, there are many more risks. Diabetes and dental health are connected in ways that are easily overlooked. Understanding these ways is vital to the health of those struggling with the disease.

Here, we will provide a brief survey of what diabetes is to lay a foundation. Then, we will dive into how diabetes is a threat to your dental health. Finally, we’ll cover how controlling diabetes supports dental health, and provide you with some practical applications.

What Does It Mean to Have Diabetes?

As you might already know, diabetes is a disease that compromises your body’s natural ability to use a hormone known as insulin. Insulin is responsible for converting the glucose (aka sugar) in your body into usable energy that your body can draw from. When a person has diabetes, that process is interrupted. The body either can’t produce as much insulin as it needs, or else can’t properly use the insulin that it has.

This seriously compromises a person’s health. A lot could be said about the serious ramifications of uncontrolled diabetes and how it hurts the body.

Since we’re dentists, let’s focus on one health impact of diabetes that is often under-discussed: that of diabetes on your dental health.

How Do Diabetes Threaten Dental Health?

With the body’s natural ability to convert glucose into energy broken, you can imagine that there would be excess sugar in the body. The elevated blood sugar associated with diabetes, as well as other features such as a weakened immune system, put diabetic patients at a disadvantage when it comes to oral health.

Gingivitis

First of all, those with diabetes are at a heightened risk of developing gingivitis—the first stage in gum disease. In fact, gingivitis has been cited as the most common oral health problem among those suffering from diabetes. This makes sense when you think about it: gum disease is a result of bacteria feasting on the sugar and debris in your mouth, and diabetes increases the sugar in your mouth bacteria to feed on.

Periodontitis

Periodontal disease is simply gum disease in its more advanced stages. Like gingivitis, it thrives off the increased sugar that diabetes allows for. The National Institute for Dental and Craniofacial Research confirms that people are indeed more likely to suffer periodontal disease if they also have diabetes.

The trouble doesn’t end there. The ADA explains, “Poor blood sugar control raises risks for gum problems, especially as we age. And this can set up a vicious cycle, since serious gum disease can cause blood sugar to rise, making diabetes even harder to control and elevating your risks for infection.” In other words, the cycle is self-perpetuating. Heightened blood sugar may cause gum disease, and in return, gum disease raises blood sugar. Rinse, and repeat. This is why it’s so crucial to attempt to keep blood sugar levels as close to normal as possible and to cut gum disease off at the source.

Infection

Did you know that diabetes weakens your immune system? When you think of a weak immune system, you probably think of someone who’s the first to catch a cold. But in reality, having a compromised immune system means much more than that. For those with diabetes, they would have a harder time healing from and managing infections such as thrush, a painful condition where the mouth develops patchy white spots on the tongue.

Trouble Healing from Wounds

Along the same lines, the body simply can’t bounce back from wounds as quickly when one is suffering from diabetes. The compromised immune system means the body just can’t respond as well to repair any damage it faces; it may not even recognize attacking bacteria as a threat. If the body does not recognize that a certain bacteria or virus is causing damage, then it will not work to make amends.

Dry Mouth

Unfortunately, dry mouth is par for the course with diabetes. The Cleveland Clinic cites dry mouth as one of the first recognizable signs of having the disease. Elevated blood sugar levels reduce a person’s saliva, leaving them the uncomfortable feeling we know as dry mouth. They recommend rightly that if you are experiencing dry mouth and believe it could be diabetes, you should speak with a healthcare provider right away.

Burning Mouth Syndrome

Being more susceptible to infections also exposes diabetic patients to the risk of burning mouth syndrome, which is basically exactly what you would expect. Those suffering from this syndrome experience a burning sensation of the mouth that may worsen as the day goes on. Some have also reported dryness and taste alteration.

Dental Health Best Practices for Those Suffering with Diabetes

Now that we understand the various threats to dental health posed by diabetes, we can look at some positive solutions. Of course, these steps can’t remove your diabetes. But they can help you do your part to guard against the damage diabetes can do to your dental health.

· Stabilize your blood sugar.

It’s important to try to keep your blood sugar as close to normal as you can, both for your overall health and for your dental health. The Cleveland Clinic notes, “If you’ve had an episode of low blood sugar (also called an insulin reaction) in the past, you are at increased risk to have another one. Tell your dentist when your last episode was, how frequently such episodes occur, and when you took your last dose of insulin (if you take insulin).”

· Avoid unnecessary dental procedures if your blood sugar isn’t managed.

This doesn’t mean you should avoid emergency procedures, such as having an abscess removed—that’s a problem which could escalate quickly, and even become life-threatening if left untreated. But if the procedure is not urgent and your blood sugar is unstable, it may be wise to wait.

· Remember that healing from dental procedures may be slow.

As the Cleveland Clinic explains, “People with unmanaged diabetes do not heal quickly after oral surgery or other dental procedures because blood flow to the treatment site can be damaged.” Knowing this ahead of time, you can be prepared to heal slowly, and to follow your dentist’s instructions fully so that the process doesn’t take any longer than it has to.

· Talk to your dentist about how to stop dry mouth.

It is crucial that dry mouth be cured, not only for comfort’s sake, but also because saliva plays a key role in preventing tooth decay and keeping everything in the mouth running smoothly. Your dentist may prescribe you a special medicine to stop dry mouth. You can also always up your water intake. Or suck on sugar-free candy, or chew sugar-free gum to try and stimulate saliva production.

· Stop smoking.

Besides the negative overall health consequences that smoking is well-known for, it also worsens gum disease. If you suffer from diabetes and a habit of smoking, your risk factors for gum disease soar and ability to fight it plummets.

· Invest in high-quality dentures.

Diabetic patients are likely to experience discomfort with dentures for a variety of reasons, from not having enough saliva to bone recession. One dentistry explains, “Gums that are vulnerable to bacterial infection are also vulnerable to damage from poor-fitting economy dentures. This can lead to gum recession, and, in some cases, may even lead to exposed bone under dentures.” As you might imagine, this is uncomfortable for many patients. Thus, it makes sense for diabetic patients to invest in high-quality dentures. While it may be more expensive up-front, the payoff is worth it.

· Be vigilant about the basics.

In spite of the risk of many health complications that diabetic patients, perhaps the best advice is simply to brush your teeth. The basics of oral health, such as tooth-brushing, flossing, or mouthwash, are easily overlooked. But they shouldn’t be so easily discounted. These fundamentals go a long way in determining whether a diabetic patient will have a healthy mouth or succumb to the challenges of their disease. If you don’t floss very often, there’s no time like the present to start! Being vigilant about the basics is crucial in overcoming the adverse effects of diabetes on dental health.

Final Thoughts

According to the ADA, every year, “1.5 million more people are diagnosed [with diabetes], including an estimated 210,000 children and teens under 20 years old.” That’s 1.5 million more people who are at heightened risk of dental health complications. You may be one of these 1.5 million. Maybe one of them is one of your children. Whoever in your life is affected by this disease, it’s important to recognize that the consequences aren’t just fatigue or a tingling in the hands and feet. Diabetes has far-reaching consequences, even for your dental health.

Today, we explored what those consequences looked like: gingivitis, periodontitis, infection, difficulty healing from wounds, dry mouth, burning mouth syndrome. Thankfully,

there are ways that a diabetic patient can combat their disease, such as maintaining a close watch on blood sugar and attempting to regulate dry mouth. If you are experiencing symptoms that you believe match those of diabetes, speak to a healthcare provider as soon as possible. If you are concerned for your dental health, we would be happy to talk that through with you. Contact our office today to schedule your next appointment with Dr. Wilson today!