Oral Health and Diabetes

By Robert S. Leland, DMD
You may not be aware of it, but your mouth is an excellent indicator of your overall health. Dental practitioners now know that as many as 90% of serious systemic problems elsewhere in the body, such as heart disease and liver disease, can trigger abnormal conditions in the mouth. In fact,one of the major concerns in dental medicine today, both in research and practice, is diabetes. The American Diabetes Association estimates that currently 25.8 million Americans are diabetics – but that isn’t the whole of it. Statistics from the Centers of Disease Control and Prevention estimate that some 79 million more Americans over 20 years of age have what is called pre-diabetes – blood glucose levels that are higher than normal but not yet high enough to be defined as true diabetes. Many of those people will likely develop a variant called Type 2 diabetes within 10 years.
The interrelationship of oral health to diabetes is vital issue for dentists, since it’s been shown that diabetes and the mouth have a common link in blood sugar. If, for any reason, blood sugar levels are out of control in your body, then blood sugar levels in your mouth likely will be out of control as well. The diabetic body either does not produce enough insulin or produces cells that “resist” insulin. Since insulin enables your body to break down sugars and starches from food into glucose—blood sugar—and transports it from the blood into cells used as energy, any deficiency of insulin is going to cause glucose to build up in the blood.
When that happens and blood glucose levels rise to abnormal levels, a long list of ensuing complications can result. In the dental chair, one such development is rampant tooth decay. With all that uncontrolled blood sugar to feed on, bacteria in the mouth find a receptive home in which to thrive and multiply. They will likely attack a tooth’s protective enamel layer. Eventually, the enamel breaks down, allowing decay to develop. Similarly, uncontrolled blood sugar levels reduce the body’s first line of defense against infection — white blood cells — which puts oral health at risk in another way: glucose-fueled bacteria teeming around the gums opens the gates to periodontal disease. Gum disease produces infection and inflammation that can actually fuel diabetes, making it harder to control.
Tooth and gum problems can happen to anyone, of course, and they don’t necessarily portend diabetes or its predecessor. Our team here in Hanover depends on regular examinations and cleanings to look out for symptoms that may signal budding problems. We check for red, sore, and swollen gums; bad breath; a bad taste in the mouth; loose or sensitive teeth; bleeding gums; gums pulling away from your teeth; a bite that feels different, or
dentures that no longer fit well. Any of these, especially in combination with known diabetes risk factors, are red flags for me, as well as for our team of hygienists. Since statistics show that members of a dental team usually see a patient more often than any other healthcare provider, we are best equipped to monitor you. If your visits are regular enough, our team can often detect oral signs and symptoms of pre-diabetes or diabetes even before blood testing or physical examination has confirmed the diagnosis.
We’ve all heard the drill for good oral-health care: have a dental checkup at least every six months and regular cleanings two or three times a year. Moreover, if you are overweight, underactive, have diabetics in your family or have been diagnosed with pre-diabetes – you have a powerful motivation for checking in regularly. Keeping us updated on your medical history, changes in your condition, and modifications of medications provides us with diagnostic tools to target and treat problems in the early stages.
You can – and should – use regular visits to talk about issues that impact your health. Even some that may seem to be outside the purview of dentistry. Don’t be afraid to ask us questions like these:
What problems should I look for that could signal a systemic problem or disease? What type of information does my dentist need to know about my health history to evaluate my oral health?
How do my oral health habits — how often I brush and floss and with what tools and techniques — affect the rest of my body, not just my gums and teeth?
Your dental team is one of your best allies. A recent study of diabetics in the Journal of the American Dental Association found that those who received regular dental care reduced both their diabetes-related ED visits and hospital admissions significantly.Whether you are pre-diabetic or simply healthy-and-committed-to-staying-that-way, the connection between good oral health and whole body health is one of the most important reasons to maintain a routine of regular dental care. Stay with it and you’ll enjoy not only a healthier smile, but a healthier body as well.