Diabetes: gingivitis and other dental complications

Diabetes is a chronic disease that continues to grow worldwide.

While the disease is common, its causes remain unclear.

Although there are treatments, diabetes wears down the body prematurely and the oral system is no exception.

To better understand its influence on the body in general and the teeth in particular, here is a complete guide on diabetes, its consequences, as well as the behaviors to adopt to limit its harmful effects on the teeth.

What is diabetes?

Diabetes is a chronic over-supply of sugar in the blood that results in high blood sugar levels.

A person with diabetes is considered to have fasting blood glucose levels of 1.26 grams per liter or higher on two occasions, or 2 grams per liter or higher at any time during the day.

Key figures

• 60 million people with diabetes in Europe;
• Approximately 3.4 million people a year worldwide die from high blood sugar;
• The WHO predicts that the number of diabetes-related deaths will double between 2005 and 2030;
• 3 main causes of the increase in diabetes cases: lack of activity, junk food and obesity.

The three types of diabetes

Three types of diabetes are listed.

Type 2 diabetes is in the majority, accounting for 92% of patients, followed by type 1 diabetes, which accounts for 6%, and the remaining 2% of patients with gestational diabetes, which occurs during pregnancy. Women who develop it are then likely to develop type 2 diabetes.

What are the consequences of diabetes?

Recurrent hyperglycemia has serious consequences for the body. The nerves and blood vessels that innervate our entire body are altered.

Eventually, complications include blindness, stroke, heart attack, erectile dysfunction and kidney failure. Damaged nerves and vessels often lead to foot amputations.

Adapting your diet

As a type 2 diabetic, it is advisable to adapt your diet and follow the following recommendations:

• eat 5 fruits and vegetables a day;
• 3 dairy products daily;
• limit fat and alcohol;
• eat meat, fish or eggs 1 to 2 times a day.

For people with type 1 diabetes, you need to be more responsive to your insulin treatment and quantify your carbohydrate intake accordingly before injecting the right dose of insulin.

The Influence of Diabetes on Oral Health

No matter what type of diabetes you have, high blood sugar has a negative impact on your entire body, including your teeth and gums. It weakens the immune system and weakens the anti-infectious defenses.

This makes diabetics more likely to develop infections in the mouth. More than anyone else, they need to take very good care of their oral health.

Medication

The drugs are targeted, but still impact the entire body. Depending on the type of diabetes and the treatments prescribed, these can have a harmful influence on the teeth by weakening them.

Quality and quantity of saliva

Diabetics produce less saliva, a phenomenon that can be aggravated by medication. The lesser saliva is also more viscous and sweeter, which favors the transformation of plaque into tartar.

The latter is a blessing for the bacteria that proliferate there and attack the teeth, gums and then the jawbones. Sometimes a dental cyst can develop.

On the other hand, diabetics are susceptible to xerostomia: the mouth and tongue are dry due to hyposialia, the lack of saliva.

Saliva is also used to clean the teeth, and in its absence, bacteria develop even more easily.

If you experience dry mouth, try to take a sip of water into your mouth as often as possible and gargle with it.

Allicin, a major compound in garlic, helps fight the disease of diabetes.

Dental health

Your mouth naturally contains many types of bacteria. When starches and sugars in foods and drinks interact with these bacteria, a sticky film called plaque forms on your teeth.

Damaged tooth enamel

The acids in plaque attack the surface of the teeth, enamel and dentin.

The higher your blood sugar, the more sugars and starch you eat and the more acid wears away at your teeth, causing cavities.

The gums are irrigated by capillary blood vessels that diabetes alters. As circulation is impaired, the gums are more susceptible to damage and have a harder time healing.

Bleeding gums

Diabetes reduces your ability to fight bacteria. If you don't remove plaque by brushing and flossing regularly, it hardens under your gums and turns into tartar.

Over time, your gums swell and bleed easily. This is called gingivitis.

If left untreated, gingivitis can lead to a more serious infection called periodontitis, which destroys the soft tissue and bone that support your teeth. Eventually, teeth become loose and fall out.

Immune dysfunction also results in ulcers and fungal infections, such as oral thrush caused by the fungus Candida albicans.

Oral thrush causes painful white or red spots inside the mouth and at the corners of the mouth.

What are the solutions to reduce the consequences of diabetes on the teeth?

Diabetics must adopt the appropriate dietary behaviors as advised by their treating physician. When it comes to their oral health, they need to be extra vigilant.

Diabetics should have two dental check-ups per year to intervene and stabilize a possible infection before it gets too big.

On a daily basis, you must insist on impeccable hygiene: brushing your teeth after each meal, flossing and spraying at least once a day. Electric toothbrushes are more effective and therefore recommended.

If smoking is never recommended, it is even less so for diabetics. Smoking clogs teeth and heats up already weakened gums.

In case of a dental emergency, contact your dentist or the 24-hour service.

The antibiotic flash

Your dentist should be aware of your diabetes. The type of disease does not matter, but it is the blood sugar balance that will be considered. You must give them access to your regular test results.

Based on the status of your glycated hemoglobin measured by blood tests every three months, he will be able to observe the status of your blood sugar balance.

If the balance is good, there are no special precautions to take. However, when your blood sugar is out of balance, he will wait for better results before proceeding with heavy care, such as extractions or implants.

For lighter care, such as routine scaling or filling of cavities, he will perform an antibiotic prophylaxis, also known as an antibiotic flash.

In diabetes, the immune system is deficient. It has an influence on bleeding, healing power and the risk of infection, so extra care should be taken before any procedure.

Antibiotic prophylaxis is a preventive antibiotic therapy. This involves administering an antibiotic that will prevent an infection from developing. This will prevent bacteria from being transmitted in the bloodstream.

Conclusion

Having bad teeth is not a fatality if you are diabetic, but it does require extremely careful oral hygiene and two check-ups per year at the dentist.

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