IN the same way that every Guyanese has a relative, a friend, or someone who lives in the United States, similarly, they know someone who has Diabetes. So, while I may not be able to give accurate statistics, judging from my professional experience, I know that Diabetes is a common condition among the population.
This condition is not a disease but a syndrome. A syndrome could be considered a group of diseases with a single cause. People who have Diabetes lack a certain type of hormone called insulin, which is responsible for the body’s utilisation of sugar, proteins and fats.
The consequence is that the diabetic usually experiences bad heart, bad eyes, chronic weakness, muscular wasting and complications reflected in the mouth, among other serious conditions. They frequently experience persistent thirst, and their skin itches often.
The oral symptoms are believed to occur more quickly and to be more severe in uncontrolled Diabetes. Diminished salivary flow and burning mouth or tongue are common complaints. The area under both
ears may swell due to concomitant enlargement of the parotid glands.
Diabetics produce sugar in their saliva. This relatively high glucose content inevitably results in altered plaque and the normal types of bacteria found in the mouth. This situation influences the development of gum disease and dental caries. Obviously, the diabetic does not have to eat foods containing sugar to have sugar in their mouth, and it is well known that sugar results in dental caries.
An increased incidence of tooth decay has been found in association with uncontrolled or poorly controlled Diabetes in both humans and experimental animals. This no doubt relates to increased glucose levels in saliva.
The uncontrolled diabetic has an increased susceptibility to mouth infections, including gum disease, the major cause of tooth loss worldwide. Also seen commonly is the thickening of the gums and delayed healing. The diabetic condition often destroys the alveolar bone which surrounds each tooth. Apart from that, the blood cells bound with the task of combating invading germs seem to be rendered ineffective by the elevated glucose content in the blood. This simply
means that the condition increases the chance of the victims losing their teeth.
A persistent dry mouth accompanied by opportunistic yeast infections is often seen in people with Diabetes. Altered taste sensations have been described as an early feature of Diabetes in some individuals. This may result from altered glucose receptors or mild manifestations of diabetic nerve disease. Treatment of Diabetes is designed to lower blood glucose levels and prevent the complications associated with the disease. Evidence suggests that rigid metabolic control of blood glucose levels is important to successful therapy. Diet control has been used for many years to control the disease by reducing the intake of starches and sugars and by minimising body fat.
People with Diabetes should not receive elective dental treatment unless their condition is stabilised. Dental practitioners in all state clinics are instructed that dental treatment for such patients should be provided only with the aid of medical advice and appropriate care. In cases of emergency procedures, prophylactic antibiotics should be used to minimise the potential for postoperative infections and delayed wound healing.
