Keeping Your Teeth Healthy

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How can diabetes hurt my teeth and gums?

Tooth and gum problems can happen to anyone. A sticky film full of germs (called plaque) builds up on your teeth. High blood glucose helps germs (bacteria) grow. Then you can get red, sore, and swollen gums that bleed when you brush your teeth.

People with diabetes can have tooth and gum problems more often if their blood glucose stays high. High blood glucose can make tooth and gum problems worse. You can even lose your teeth.

Smoking makes it more likely for you to get a bad case of gum disease, especially if you have diabetes and are age 45 or older.

Red, sore, and bleeding gums are the first sign of gum disease. This can lead to periodontitis (PER-ee-oh-don-TY-tis). Periodontitis is an infection in the gums and the bone that holds the teeth in place. If the infection gets worse, your gums may pull away from your teeth, making your teeth look long.

Call your dentist if you think you have problems with your teeth or gums.

The most common oral health problems associated with diabetes are:

• Tooth decay
• Periodontal (gum) disease
• Salivary gland dysfunction
• Fungal infections
• Lichen planus and lichenoid reactions (inflammatory skin disease)
• Infection and delayed healing
• Taste impairment

Oral candidiasis is a fungal infection in the mouth and appears to occur more frequently among people with diabetes, including those who wear dentures. Your dentist may prescribe antifungal medications to treat this condition.

Lichen planus is a skin disorder that produces lesions in the mouth. A more severe type of Lichen planus involves painful ulcers that erode surface tissue. Your dentist may prescribe a topical anesthetic or other medication to reduce and relieve the condition, although there is no permanent cure.

Some people with diabetes have reported that their taste for sweets is diminished, although the taste impairment is usually not severe. Altered taste sensations may influence food choices in favor of sweet tasting foods with highly refined carbohydrate content, which can worsen the patient’s dental and overall health.

How do I know if I have damage to my teeth and gums?

If you have one or more of these problems, you may have tooth and gum damage from diabetes:

• Red, sore, swollen gums
• Bleeding gums
• Gums pulling away from your teeth so your teeth look long
• Loose or sensitive teeth
• Bad breath
• A bite that feels different
• Dentures (false teeth) that do not fit well

How can I keep my teeth and gums healthy?

Keep your blood glucose as close to normal as possible.

• Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times.
• Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth.
• If you wear false teeth, keep them clean.
• Ask the person who cleans your teeth to show you the best way to brush and floss your teeth and gums. Ask this person about the best toothbrush and toothpaste to use.
• Call your dentist right away if you have problems with your teeth and gums.
• Call your dentist if you have red, sore, or bleeding gums; gums that are pulling away from your teeth; a sore tooth that could be infected; or soreness from your dentures.
• Get your teeth and gums cleaned and checked by your dentist twice a year.
• If your dentist tells you about a problem, take care of it right away.
• Be sure your dentist knows that you have diabetes.
• If you smoke, talk to your doctor about ways to quit smoking.

How can my dentist take care of my teeth and gums?

Your dentist can help you take care of your teeth and gums by:

• Cleaning and checking your teeth and gums twice a year
• Helping you learn the best way to brush and floss your teeth and gums
• Telling you if you have problems with your teeth or gums and what to do about them
• Making sure your false teeth fit well

Plan ahead. You may be taking a diabetes medicine that can make your blood glucose too low. This very low blood glucose is called hypoglycemia. If so, talk to your doctor and dentist before the visit about the best way to take care of your blood glucose during the dental work. You may need to bring some diabetes medicine and food with you to the dentist's office.

If your mouth is sore after the dental work, you might not be able to eat or chew for several hours or days. For guidance on how to adjust your normal routine while your mouth is healing, ask your doctor:

• What foods and drinks you should have
• How you should change your diabetes medicines
• How often you should check your blood glucose

SOURCES:
American Dental Association. Oral Health Topics: Diabetes. (Accessed 12/06/10).

National Institutes of Health. Adapted and excerpted from NIH Publication No. 03-4280. (Accessed 12/06/10).