How Does Diabetes Affect My Teeth and Gums?

What is Diabetes Mellitus?
Diabetes is a lifelong (chronic) disease in which there is a high level of sugar in the blood. Insulin is a hormone produced by the pancreas in your body to control this blood sugar. Diabetes thus, can be caused by too little insulin production, resistance to insulin, or both.
To understand diabetes, it is important to first understand the normal process by which food is broken down and used by the body for energy. Several things happen when food is digested:
A sugar called glucose is absorbed into the bloodstream. Glucose is a source of fuel for our body. The body now produces insulin. The role of this insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be stored.Diabetics have high blood sugar because their body cannot move sugar into fat, liver, and muscle cells to be stored for energy.
Why does this happen?
Their pancreas either does not make enough insulin or the body cells do not respond to insulin normally.Both of the above ca also occur
There are three major types of diabetes:
Type 1 diabetes can occur at any age, but it is most often diagnosed in children, teens, or young adults. In this disease, the body makes little or no insulin. Daily injections of insulin are needed to control this. The exact cause is unknown.
Type 2 diabetes makes up most of diabetes cases. It most often occurs in adulthood, but teens and young adults are now being diagnosed with it because of high obesity rates. Many people with type 2 diabetes do not know they have it. In this type of Diabetes the cells of the body require higher insulin levels to clear the blood of sugar
Gestational diabetes is high blood sugar that develops at any time during pregnancy in a woman who does not have diabetes.
Complications of Diabetes:
Periodontitis: Periodontitis is an infection of the supporting structures of the teeth ie, the Alveolar bone the ligaments and the gingiva on top. Uncontrolled diabetics show increased levels of gum infections which results in early loss of their teeth. In uncontrolled diabetics there is increased production of advanced glycation end products.these do not allow the collagen to be remodeled therefore the collagen tends to break down at the slightest infection resulting in multiple abscess in the gums
Diabetic cardiomyopathy: damage to the heart, leading to diastolic dysfunction and eventually heart failure.
Diabetic nephropathy: damage to the kidney which can lead to chronic renal failure, eventually requiring dialysis. Diabetes mellitus is the most common cause of adult kidney failure worldwide in the developed world.
Diabetic neuropathy: abnormal and decreased sensation, usually in a 'glove and stocking' distribution starting with the feet but potentially in other nerves, later often fingers and hands. When combined with damaged blood vessels this can lead to a diabetic foot. Other forms of diabetic neuropathy may present as mononeuritis or autonomic neuropathy. Diabetic amyotrophy is muscle weakness due to neuropathy.
Diabetic retinopathy: growth of friable and poor-quality new blood vessels in the retina as well as macular edema (swelling of the macula), which can lead to severe vision loss or blindness.
Is there an association between gum disease and Diabetes?
For the nearly 50 million Indians that have diabetes, many may be surprised to learn about Periodontitis being an unexpected complication associated with this condition. Research shows that there is an increased prevalence of advanced gum disease called periodontitis among those with diabetes, The American Diabetic Association has added periodontitis to the list of other 5 established complications associated with diabetes, macro vascular disease such as heart disease, micro-vascular diseases, retinopathy, nephropathy (renal disease) and neuropathy.
If I have gum disease like Periodontitis will I have more diabetes?
Research is showing that when gum disease/ periodontitis is present it results in increased levels of TNF-alpha. The ability of the body to respond to insulin decreases therefore the patient requires a higher dose of insulin or oral hypoglycemic drugs to control their rising blood sugar levels. Research has also shown that once this gum disease is controlled the amount of medication required reduces.
Is There a Two-Way Street?
Yes,the relationship between serious gum disease and diabetes is two-way. Not only are people with diabetes more susceptible to serious gum disease, but serious gum disease may have the potential to affect blood glucose control and contribute to the progression of diabetes. Research suggests that people with diabetes are at higher risk for oral health problems, such as gingivitis (an early stage of gum disease) and periodontitis (serious gum disease). People with diabetes are at an increased risk for serious gum disease because they are generally more susceptible to bacterial infection, and have a decreased ability to fight bacteria that invade the gums.
Diabetics should get their periodontal health examined by a periodontist every 6 months.
If I Have Diabetes, am I at Risk for Dental Problems?
If your blood glucose levels are poorly controlled, you are more likely to develop serious gum disease and lose more teeth than non-diabetics. Like all infections, serious gum disease may be an important factor in causing blood sugar to rise. Other oral problems associated to diabetes include: thrush, an infection caused by fungus that grows in the mouth, and dry mouth which can cause soreness, ulcers, infections and cavities.
How Can I Help Prevent Dental Problems Associated with Diabetes?

Oral Thrush – Causes, Symptoms and Treatment

Oral candidiasis is an infection of yeast fungi of the genus Candida on the mucous membranes of the mouth. It is frequently caused by Candida albicans, or less commonly by Candida glabrata or Candida tropicalis. Oral thrush may refers to candidiasis in the mouths of babies, while if occurring in the mouth or throat of adults it may also be termed candidosis or moniliasis.

Thrush refers to candida infection of the mouth and oral areas. The term "thrush" is sometimes also used incorrectly to describe a Candida infection of the genital area; see vaginal candiasis or penile candidiasis. Thrush is common in infants, and can arise particularly after a course of antibiotics. Otherwise, oral thrush usually affects only the ill, particularly those with a weakened immune system.

What causes thrush?

Small amounts of the candida fungus are present in the mouth, digestive tract, and skin of most healthy people and are normally kept in check by other bacteria and microorganisms in the body. However, certain illnesses, stress, or medications can disturb the delicate balance, causing the fungus candida to grow out of control, causing infection. Medications that upset the balance of microorganisms in the mouth and may cause thrush include corticosteroids, antibiotics, and birth control pills.

Signs and Symptoms:

Thrush is easily identified as white spots or raised clusters on the surface of the tongue. These patches are often curd-like, and can be found on the roof of the mouth, inside the cheeks and on the back of the throat. Thrush on the tongue can cause dry mouth. When the clusters are coating the throat, swallowing becomes difficult and painful. Some foods, such as carbonated beverages, may aggravate the pain.

The symptoms of oral thrush include clusters of raised, white, patches on the tongue, roof of the mouth and cheeks. When bushing the teeth the white film can be brushed off and the inflamed area may bleed. If this is left untreated it can cause serious problems. Thrush can spread all through the mouth, down the esophagus into the stomach and the lungs. Thrush can cause mouth ulcers and bad breath. People that take antibiotic treatments, such as people with anemia, HIV patients, and people with immune system problems are at a high risk of oral thrush.

The Facts

Oral thrush is a yeast infection of the mouth caused by uncontrolled growth of an organism called Candida albicans.Candida albicans is an organism that normally makes a quiet home for itself on your skin and doesn't bother anyone. We all carry this organism on our skin, in our mouth, in our gastrointestinal tract (gut), and, in the case of women, in the vagina. Occasionally the yeast multiplies uncontrollably, causing pain and inflammation. When this occurs, it is called candidiasis. It is also known as moniliasis or a yeast infection.

Treatment

There are two goals when treating oral thrush in adults. The first is to improve your immune system's ability to function. For example, in diabetics, good control of diabetes may be enough to clear the infection without other treatment. The second is to directly treat the infection. For this purpose, your doctor may prescribe an antifungal mouthwash or lozenges to suck on. These are usually used for 5-10 days. If they don't work, other medication may be prescribed.

Author: peterhutch

5 Health Tips From Dentists

Why does this happen?
The very first thing you should know is that an instrument is only as good as the wielder. That means, you may be using the best dental products but if you aren't combining them with basic oral hygiene procedures; they are of no use. To learn more, look at these top tips by which you can ensure better oral health with minimum use of dental products.
1. Use only fluoridated products - Fluoride is actively absorbed by the tooth surface making it harder and much more resistant to cavities. Check the ingredient list on the toothpaste to find its fluoride content and combine it with a fluoridated mouthwash and a fluoride-impregnated floss to ensure better oral health. If you already have cavities, you can use fluoride-leaching cements like GIC to seal the tooth and to prevent further cavities. Do be careful about the fluoride in your water supply though as too much fluoride can cause a problem called as dental fluorosis in growing teeth.
2. Use dental sealants - Dental sealants cover surface imperfections and prevent food impaction. The plastic protective coating can be applied in ten minutes and it lasts for a very long time. Get in touch with your dentist for additional information.
3. Learn proper brushing techniques - Most people scrub away at their teeth thinking that pressure is the best way to clean teeth. However, they couldn't be more wrong. Technique is far more important than pressure and you dentist will teach you the right method for cleaning your teeth.
4. Clean your tongue - 90% of all bad breath cases are due to a woolly tongue covered with food particles. For fresher breath, be sure to brush your tongue, too, use the same toothbrush or a special tongue cleaner to scrape and clean the tongue. This will dramatically improve oral health and oral odour as well. You should replace your toothbrush every three months.
5. Visit your dentist at least once in six months - Everyone has to visit the dentist at least once in six months. This screening visit will help the dentist find and seal cavities, assess your dental health and remove scaly white deposits called plaque.
Do not make the mistake of considering no dental pain as perfect dental health. By the time pain starts, it's actually too late to do anything. Visit your dentist regularly and follow these tips to ensure better oral health.

By Dr Sunitha Prasad