Type 2 Diabetes and Dental Care: 8 Problems and 9 Preventative Solutions

People with type 2 diabetes are more likely to suffer oral health complications. In fact, your risk is increased 2-3 fold compared with the rest of the population.

This makes it especially important for you to understand what the issues can be, along with dental care practices you can use to prevent the complications.

The most important thing to realize is that both your teeth and gums are affected by glucose levels in the blood. The higher your blood sugar levels, the more risk there is for developing all types of complications.

Don’t ignore your dental health because if untreated, over time, all areas of the mouth and even bone structure can be compromised.

Here we talk about 8 possible dental problems, along with 9 preventative solutions.

8 Diabetes Dental Problems

#1: Gingivitis

Gingivitis is inflammation of the gums, the earliest stage of gum disease. Symptoms are irritated, swollen, red gums. If treated early, gingivitis may not progress to one of the following, more serious conditions.

#2: Periodontitis

This is a gum infection resulting in teeth pulling away from the gums. Pockets between teeth and gums can fill with germs or pus and become deeper. Eventually gum surgery may be needed. As the infection worsens, bone is destroyed and teeth may become loose and need to be pulled.

#3: Dental Caries

These are also known as cavities. They occur due to bacteria breaking down the hard tissue of the tooth, resulting in tooth decay. Cavities need to be filled with a composite material to avoid further erosion.

#4: Tooth Loss

If the teeth are unable to be saved, they may need to be pulled. This can cause distortion in remaining teeth and jaw/bone structure. If many or all teeth are pulled, eventually dentures will be needed to masticate food. Keep in mind that dentures are not an ideal replacement for real teeth. There is a significant loss of bite power because dentures are not connected to the bone structure in the way real teeth are.

#5: Candidiasis

This is fungal disease caused by injury to the soft tissue of the tongue and around the mouth caused by Candida. This is the same bacteria that causes yeast infections. Symptoms include white patches in the mouth and on the tongue.

#6: Abscesses

An abscess is a painful pus-filled swelling that occurs when teeth or gums become injured due to trauma or infection. These infections will not go away on their own, so if you have one, it is crucial to seek treatment asap so your dentist can order you antibiotics to drain the abscess, clean the area and treat the infection. If left untreated, the infection can spread to the bones and surrounding teeth.

#7: Dry Mouth

Also called ‘xerostomia,’ dry mouth can lead to soreness, ulcers, infection and tooth decay in addition to being generally irritating and uncomfortable.

#8: Thrush

People with diabetes are more likely to take antibiotics, which unfortunately can lead to fungal infections in the mouth and/or on the tongue

Why is There Increased Dental Risk in Type 2 Diabetes?

The increased risk of dental complications with diabetes is likely due to increased risk of bacterial infections and/or the accumulation of something called advanced-glycation-end-products (AGEs). These are formed when protein or fat link up with excess sugar in the bloodstream and worsen chronic disease (including diabetes).

So the overall message here is the more you can control blood sugar levels and keep them within normal healthy range, the less you’re at risk for complications.

Not only does elevated glucose increase risk for dental disease, but infections in the mouth can worsen blood glucose control. Poor tooth care has greater consequences than just oral health. We know that periodontal disease is a risk factor for mortality from ischemic heart disease. Additionally, people with periodontal disease have 3 times the risk of death from heart disease and neuropathy.

Periodontal disease does not have any symptoms, so it’s important to schedule regular preventative dental care appointments so you can identify potential problems. If it is addressed early, proper treatment can improve A1c and minimize pain and discomfort that will perpetuate if the problem persists.

During a dental exam, you will be assessed for gum redness, swelling, bleeding, foul odor, loose teeth and pain.

8 Tips To Prevent Dental Problems With Diabetes

The good news is, there are several steps you take take in order to prevent dental problems. Below are some of the things you can do to ensure healthy teeth, gums and mouth.

#1: Proper brushing daily  

Use a soft bristled toothbrush that fits in your mouth easily. If you have arthritis, an electric toothbrush is a great option. Aim your toothbrush at a 45 degree angle where your teeth and gumline meet, and brush in circles with slight pressure. Remember to brush both the insides and outsides of your teeth, including the outsides of back teeth. Finally brush your tongue, which can harbor bad bacteria and needs to be cleaned regularly as well. It’s optimal to brush after every meal, but this isn’t always practical. Be sure to brush at least twice daily.

#2: Proper flossing daily

Flossing is super important–brushing cannot get stuck food parts out that are lodged between your teeth. If you see what comes out when you floss–you’ll know these. Take about 12” or so of dental floss and wrap each end around a finger on each hand. Guide it gently between the crevices of each of your teeth in an up and down motion. If you have a difficult time winding/unwinding floss, you can get pre-threaded flossers or use a water flosser. Be sure to floss at least once a day.

#3: Schedule regular dental exams and professional cleanings

Tooth cleaning should be scheduled every 6 months at minimum, but your doctor or dentist may recommend more frequent visits based on your particular situation. Be sure to schedule an appointment with a dentist if you notice any of the following: red or tender gums, bleeding gums, loose teeth, changes in alignment, new sensitivity to heat or cold, poor fitting dentures, difficulty swallowing, or sores/ulcer that aren’t healing.

#4: Avoid mouth rinses which contain alcohol

These are likely to lead to dry mouth, which in turn can promote dental caries. Additionally, check ingredients on mouthwashes to be sure they do not contain sugar.

#5: Take care of your dentures if you have them

Remove dentures at bedtime and clean and rinse thoroughly. Dentures are regularly contaminated by bacteria and if left unclean can infect the mouth and teeth.

#6: Take good care of your toothbrush

Rinse your toothbrush well after brushing and keep head exposed to air to dry. Don’t cover it up or place in an enclosed container because the moisture could harbor yeast or bacteria. Replace your toothbrush every 3-4 months and after illness.

#7: Avoid smoking

Smoking impairs blood flow to the gums and slows wound healing in addition to constricting blood vessels resulting in further elevation of blood pressure.

#8: Steer clear of sugar

As if you needed another reason to quit, sugar is what primarily feeds bad bacteria in the mouth and provides energy for them to grow, thrive and go to work on your teeth and gums.

#9: Monitor your blood sugar levels

And the NUMBER ONE thing you can do to avoid complications is to keep your blood sugar levels in a healthy range.

If your levels are high it increases your risk for all types of complications. So keep working on those numbers by eating a healthy low carb diet, exercising, stressing less and getting good quality sleep.

Source: The Art and Science of Diabetes Self-Management Education Desk Reference. 2nd Ed. American Association of Diabetes Educators.