4. Time your dental appointments. Try to schedule them in the morning. "It's the best time to have dental procedures for people with diabetes because blood glucose tends to be more stabilized and you've recently tested your blood sugar, taken your medication, and had breakfast," says Stephanie Kethcart, D.D.S., owner of Stephanie K Dentistry in Phoenix, Arizona. "Normal blood glucose is between 80 and 120, but we actually like to have patients with diabetes closer to 120, especially when they're having dental work done," she says. When your blood sugar is on the sweeter side, your dentist will have a greater window of opportunity to work without worrying that your blood sugar will drop too low. Feel free to break up a long dental procedure into several visits though.
5. Know your A1C level. Your dentist will probably ask. That's the best gauge for how well controlled your diabetes is because it's an average of your blood sugar over the past three months. "You're shooting for a number below 7 percent," says Dr. Bissada. Anything above 7 signals your blood sugar isn't well controlled and can determine the dental treatment you may need or are eligible for. For example, if you've got periodontitis and need dental surgery, your dentist may not schedule it, unless it's an emergency, until your diabetes is under better control. "Patients with uncontrolled diabetes take longer to heal. During that time, their condition can become more complicated with infection," Dr. Bissada says.
6. Do your homework. Good oral hygiene is especially important if you have diabetes because your body generally can't fight off infection as well as someone without diabetes. "With diabetes, the response to infection is exaggerated, which leads to a faster breakdown of the tissues in your mouth and the support around your teeth," says Dr. Lalla. To prevent bad bacteria from easily getting a foothold between dental visits, brush your teeth twice a day with fluoridated toothpaste and an electric toothbrush — in the morning when you get up and before going to bed. "An electric toothbrush can get through to a lot of the soft plague on the tooth surface and massage the gums without wearing away the tissue," says Dr. Kethcart. Use the timer on the toothbrush or watch the clock and go at it for two minutes. Quality brushing takes that long. But don't think brushing more often is better. "Patients will tell me they brush their teeth five times a day — after every time they eat something. But it's the quality of brushing that counts, not how many times you do it," Dr. Bissada says. Also, floss or use a Waterpik before bed. Mechanical or water flossing cleans between your teeth and gums to dislodge bacteria. Brushing and flossing before bed is especially important because when you go to sleep, there's less saliva flow. "The bacteria that cause periodontal disease can proliferate because they're not being washed away like they are during the day," says Eugene Stanislaus, D.D.S., a dentist is Brooklyn Heights, New York. "If you only brushed and flossed once a day, do it before bed," he says. As a final step, use an anti-microbial rinse such as Listerine or ProHealth before bed, Dr. Bissada says. If you have dentures, brush them and your gums once a day with a soft-bristle toothbrush.
7. Seeing the dentist is cheaper than not. Seeing a dentist more often than every six months — or even just every six months — can be costly, especially if you don't have dental insurance. But just how expensive is it, really? "If you come to my office and have your teeth cleaned, it costs $164 or $328 twice a year. That's $27.33 per month or just 90 cents per day for something you use 24/7," says Vincent C. Mayher, D.M.D., M.A.G.D., a spokesperson for the Academy in General Dentistry, in Haddonfield, New Jersey. It's money well spent, especially if regular checkups help you avoid periodontitis and other more costly dental and other health problems. Consider: "Laser treatment, which is used to treat moderate to advanced periodontitis, costs $1200 per quadrant in your mouth," says Dr. Stanislaus. That's $4800 for your entire mouth. "Conventional periondontal surgery, which requires incisions and sutures, can cost much more than that," he says. Bottom line: Routine dental care can prevent complications and save money. To find an affordable dentist if you're paying out of pocket, call around to the dentists in your area and ask about prices. Or become a member of a dental site such as www.brighter.com. It offers discount plans that may shave 20 to 60 percent off your dental bill, depending on the procedure, from a network of 25,000 dentists nationwide.
Mealey, Brian L. and Thomas W. Oates. 2006. Diabetes Mellitus and Periodontal Diseases. J Periodontal 77:1289-1303 (PDF) (Accessed 07/11).
NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
Reviewed by Susan Weiner, RD, MS, CDE, CDN. 05/12.
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