7 Things Dentists Wish You Knew About Diabetes and Dental Health
If you have diabetes, your risk of periodontal (gum) disease, also known as periodontitis, is two to three times greater than it is for someone who doesn't have diabetes. Diabetes doesn't cause the gum infection but it can make it worse and progress faster, especially if your diabetes isn't well-controlled. "It's a two-way street. Periodontitis can also make your diabetes tougher to control," says Nabil F. Bissada, D.D.S., M.S.D., professor and chair of the department of periodontics at Case Western Reserve University School of Dental Medicine in Cleveland, Ohio. To avoid this vicious cycle, prevention and awareness are key. Here are 7 things dentists wish their patients with diabetes knew to reduce their risk of periodontitis and help them stay healthy.
1. Conditions in your mouth affect your whole body. Periodontitis starts with an imperceptible bacterial infection under the gum line that can trigger your body's inflammatory response, says Dr. Bissada. Harmful bacteria from your mouth can travel in your bloodstream to the rest of your body, raising the level of C-reactive protein, and other inflammatory markers, he says. Elevated inflammation can decrease insulin sensitivity, making your blood sugar harder to control and increase your risk of other inflammation-related conditions, such as atherosclerosis, which is the major cause of heart attacks and strokes. "People with diabetes are at increased risk of atherosclerosis-related complications anyway because of their diabetes, so it's even more important for them to be aware of the link between diabetes and dental health," says Evie Lalla, D.D.S., associate professor of dental medicine at Columbia University College of Dental Medicine in New York City. Bottom line: "Everything in your body is connected. Having a healthy mouth can lead to lower blood glucose levels and less chance of heart disease," says J. Nicholas Porcello, D.D.S., a dentist in Salamance, New York.
2. Periodontitis has no symptoms in the early stages. Over time, periodontitis can cause gums to bleed and become red and swollen, and erode supporting bone, says Dr. Lalla. Teeth can become loose, migrate in your mouth and fall out, which can make eating, especially fruits and vegetables, difficult. "But you're not going to experience these symptoms or any pain or an abscess — telltale signs of periodontitis — until it's in its advanced stages," Dr. Lalla says. "By that point, it's already too late," she says. Damage to your mouth and the rest of your body has already occurred.
3. You may need to see a dentist more often. If your diabetes is well-controlled, it's recommended that you need to see a dentist every six months, just as you would if you didn't have diabetes, says Dr. Bissada. If it's not under good control or you have periodontal disease to some degree, you'll need to see the dentist more frequently. Ask your dentist how often you should visit. Generally, every three to four months is typical, though you may need to go even more, depending on your situation. "If a patient's diabetes isn't well-controlled, I like to see them every one to two months," says Dr. Bissada. Regular professional cleaning and scaling to remove tartar from the teeth can help reduce the risk of infection and keep bad bacterial levels in your mouth low. Even if you're sick of going to the doctor, don't let your dental appointments slide. "Your dentist is just as much a part of your healthcare team as your eye doctor, foot specialist, and physician," Dr. Lalla says.
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