Oral care is part of diabetes treatment

Infections reduce insulin production

When a diabetic patient enters Hiissa-Lampén's office, she examines the condition of the gums particularly closely and informs the patient about the link between the condition of the gums and diabetes. Some diabetic patients have their condition in such good balance that there is nothing special about the treatment of their teeth and mouth. If the blood sugar levels vary and there are problems in the treatment, the gums are often inflamed.

Red and bleeding gums are often a sign of gingivitis, which can cause an imbalance in the blood sugar levels, which, in turn, can indicate worsening of diabetes symptoms and the need to make adjustments to the medication. At this stage, the problem must be addressed, for example, by removing tartar and improving the quality of self-care.

– Fortunately, more attention is now paid to gingivitis before it develops into periodontitis. It is a pity that, in some cases, gingivitis has already progressed to soft tissue loss, also known as periodontitis, before seeing a dentist, Hiissa-Lampén says.

Periodontitis is an inflammatory disease where the bacterial mass begins to penetrate deeply under the gum and causes damage to the tooth’s connective tissue. In the worst cases, the disease may cause teeth to loosen completely from the jaw. Periodontitis is a complicated disease also due to the fact that it does not necessarily cause any sensations. In adults, periodontitis is a major public disease, but smokers and diabetics are particularly at risk.

Like gingivitis, periodontitis also releases inflammatory cells and neurotransmitters into the body, which strain the whole body and thus weaken insulin production. In such cases, the treatment balance of diabetes gets worse, which in turn creates more problems with oral health. The vicious cycle is complete.

Caries on the tooth’s neck

Diabetes supports the development of dental caries. The disease makes the gingival crevicular fluid sugary, which may increase the likelihood of caries developing in the neck of the tooth. Oral fungal infections are also more common in diabetic patients. An infection can be detected from sensitive and red mucous membranes of the tongue and palate, for example.

In addition, diabetes impairs the healing of all oral infections. It is unfortunate, and sometimes it is also very dangerous.

– For example, inflammation of the root canal can advance to the jaw and the surrounding tissues, which may cause fatal blood poisoning at worst, says Hiissa-Lampén.

The mouth and the body are one

When you enter a dentist’s office, you may think that you are only having your teeth checked. It is not as simple as that, however.

– Dental care is understood much more broadly as general health care, says Hiissa-Lampén.

In some cases, the dentist is the first person to suspect diabetes – the first signs of diabetes can be seen in the mouth.

– If there is root caries or serious gingivitis in the customer’s teeth, I will ask them when they have last visited a doctor for a medical examination. According to estimates, up to 100,000 people in Finland suffer from type 2 diabetes without knowing it, and it is important that this condition is treated properly.

Looking after oral health supports the overall health of your entire body: good oral care keeps the blood sugar levels of diabetic patients under control, which even makes it possible to reduce the doses of medications.

Are you diabetic? Here’s how to look after your oral health:

• Brush your teeth twice a day and clean the interdental spaces every day.
• Favour toothpastes with 1,100–1,500 ppm fluoride concentration. Other pastes do not prevent the development of caries.
• Sucking on a xylitol lozenge after a meal prevents the development of cavities and increases salivation. Saliva rinses and cleans your teeth.
• If you use medication that makes your mouth dry, ask your pharmacist for products to treat dry mouth.
• Ask your dentist what is the suitable interval between dental check-ups for you.
• If your gums bleed when you brush your teeth, for example, your gums are most likely already inflamed. If careful brushing twice a day and flossing your teeth does not eliminate the inflammation, book an appointment with a dentist as soon as possible.
• If your blood sugar levels seem to fluctuate and it has already been a while since your last visit to a dentist, you should book an appointment. There may be a hidden infection in your mouth that causes problems with your sugar balance.

Sources:
Dentist Virpi Hiissa-Lampén
Health LibraryExternal link
Finnish Diabetes Association External link