Diabetes and oral health: everything there is to know!

People with type 1 and type 2 diabetes are prone to various dental complications, namely tooth decay (dental caries), dental plaque, and periodontal, or gum, disease (gingivitis and periodontitis).

These complications are closely associated with diabetes as they are at the same time the cause and the consequence of the imbalance: they aggravate the blood sugar imbalance and thus increase the risk of diabetic complications.

What dental problems are associated with diabetes?

Periodontal tissue is the set of structures that support the teeth. People with diabetes are at high risk of developing periodontal (gum) disease because they are more prone to bacterial infection and have a lower metabolism which does not help fight oral infections.

Tooth decay

Tooth decay is the destruction of tooth enamel by plaque and is mainly manifested by tooth sensitivity to hot or cold. Sugar and tooth decay are often closely linked, and for people with diabetes, it is one of the most common dental problems. Poorly controlled diabetes promotes the development of tooth decay as it causes an increase in sugar levels not only in the blood but also in the saliva.

Dry mouth

Saliva is secreted by the salivary glands. It is essential not only for keeping the mouth moisturised, but also for fighting oral infections. Therefore, a decrease in the saliva production is not without consequences. Type 1 diabetes, however, is the cause of xerostomia (dryness in the mouth) and can cause bad breath or exposure to oral infections.

Plaque

Plaque (or bacterial plaque) forms naturally at the roots of the teeth through the accumulation of bacteria, food particles and saliva between the teeth and the gums. These bacteria feed on sugar, and diabetic patients' saliva is thicker and contains more sugar, which makes them even more vulnerable. Inadequate removal can lead to the calcification of the plaque and the formation of tartar deposits, causing periodontitis.

Periodontitis

Periodontitis is an infection in which the inflammatory reaction destroys the supporting tissues of the teeth. Periodontitis affects the periodontal tissue (a group of tissues supporting the tooth) and can lead to tooth loss and bone destruction.

It should be noted that one in two diabetic patients suffers from periodontitis. Only one third of diabetic patients visit their dentist every year and only 50% understand the importance of follow-up care by a dentist.

Gingivitis

Gingivitis is caused by the chronic accumulation of plaque excreted by bacteria. Although gingival inflammation can affect anyone, it is a common dental problem in people with diabetes. Inflammation of the gum tissue results in redness and swelling of the gums when brushing the teeth, which causes bleeding. In a more advanced stage of the disease, the teeth can move with a simple touch. This is a serious complication of untreated periodontitis, which is much more common and severe in type 1 diabetes.

Other oral problems associated with diabetes also exist, such as oral thrush (oral candidiasis), an infection caused by the growth of the fungi, and ulcers.

How can diabetes-related dental problems be prevented?

Poor blood sugar control increases the risk of periodontal disease and tooth loss. Like other infections, severe gum disease can raise blood sugar levels and make diabetes still more difficult to manage.

For people with diabetes, paying attention to oral hygiene is just as important as controlling their diabetes, right from diagnosis. Therefore, keeping teeth and gums clean should be part of their daily routine.

It is important to brush your teeth properly at least twice a day and to use dental floss or an interdental brush.

It is also important to check your blood sugar levels and, if you have dentures, remove them for daily cleaning.

Unbalanced diet and smoking can increase or even worsen gum disease. Smoking cessation is therefore necessary to prevent or alleviate mouth dryness caused by diabetes.

Finally, regular visits to the dentist are essential. The dentist should be informed about the patient's health condition so that he or she can adapt the treatments. The dentist can also advise the patient about using the right equipment correctly.

During their dental appointments, patients can benefit from:

• Scaling,
  
• A detailed dental examination of the mucous membranes, periodontium, teeth, saliva secretion, etc., which is carried out to detect damage to the teeth and gums at an early stage.
  

The best preventive measures against periodontal disease are strict oral hygiene and regular dental appointments, even if there are no symptoms. Special attention should therefore be paid to daily oral hygiene which could help reduce the risk of dental infections.