Oral health for diabetics

THERE are thousands of Guyanese who are living with diabetes. If you have been diagnosed with diabetes, you may know that the disease can cause problems with your eyes, nerves, kidneys and heart, as well as other parts of your body. Diabetes can lower your resistance to infection and can slow the healing process. 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 skindisease); infection and delayed healing as well as taste impairment.

It’s essential to keep your medical records up to date. Let your dentist know if you have been diagnosed with diabetes, if the disease is under control, any other change in your medical history, and the names of all prescription and over-the-counter drugs you are taking.

When diabetes is not controlled properly, high glucose levels in saliva may help bacteria thrive. Brushing twice a day with fluoride toothpaste and cleaning once a day between your teeth with floss or an interdental cleaner helps remove decay-causing plaque. Plaque that is not removed can eventually harden (calcify) into calculus or tartar. When tartar collects above the gum line, it becomes more difficult to brush and clean between teeth thoroughly. This can create conditions that lead to chronic inflammation and infection in the mouth. Because diabetes reduces the body’s resistance to infection, the gums are among the tissues likely to be affected.

Periodontal diseases are infections of the gum and bone that hold your teeth in place. Periodontal disease often is linked to the control of diabetes. For example, patients with inadequate blood-sugar control appear to develop periodontal disease more frequently and more severely, and they lose more teeth than do people who have good control of their diabetes. See your dentist immediately if you notice any of the following: gums that bleed easily; red, swollen or tender gums; gums that have pulled away from the teeth; pus between the teeth and gums when the gums are pressed; persistent bad breath or bad taste in the mouth; permanent teeth that are loose or separating; any change in the way your teeth fit together when you bite; any change in the fit of partial dentures.

Bacteria, viruses and fungi occur naturally in the mouth. The body’s natural defences and regular oral hygiene generally keep them in check. However, under some situations, they may proliferate and impede or defeat the body’s defences. Oral candidiasis, a fungal infection in the mouth, appears to occur more frequently among people with diabetes,
including those who wear dentures. If you smoke, have high blood glucose levels or often are required to take antibiotics, you are more likely to have a problem with fungal infections in your mouth. Diminished salivary flow and increased salivary glucose

levels create an attractive environment for fungal infections such as thrush. Thrush produces white (or sometimes red) patches in the mouth that may be sore or may become
ulcers. It may attack the tongue, causing a painful, burning sensation. It also can cause difficulty in swallowing and compromise your ability to taste. Your dentist may prescribe antifungal medications to treat this condition. Good oral hygiene is critical.

Preventive oral health care, including professional cleanings at the dental office, is important if you are to control the progression of periodontal disease and other oral health problems. Regular dental checkups and periodontal screenings are important for evaluating overall dental health and for treating dental problems in their initial stages. Your dentist may recommend more frequent evaluations and preventive procedures,
such as prevention, to maintain good oral health.

In addition to brushing twice a day and flossing or using an interdental cleaner once a day, your dentist may suggest using an antimicrobial mouth rinse or toothpaste to control
gingivitis. Watch for signs and symptoms of oral disease and contact the dental office immediately when a problem arises. Practice good oral hygiene at home; follow your physician’s instructions regarding diet and medications, and schedule regular dental
checkups to maintain a healthy smile.

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