Goals/Objectives: To make and keep appointments for routine and special dental care, as needed, and to practice daily oral hygiene as instructed by your dentist.

Time Frames:

• • Brush and floss twice a day
  • Dental cleaning twice a year
  • Dental x-rays annually

Having diabetes is a major risk factor for developing periodontal (gum) disease, especially when blood glucose isn’t well controlled. One large study found about 60 percent of people with diabetes have some evidence of periodontal disease. Diabetes is the leading cause of periodontal disease. People with diabetes (both type 1 and type 2) experience three times greater risk of periodontal disease than non-diabetics.

When I lost my job (and, with it, my health care insurance) and had to move to another town, get established with a new health care plan, and find a new dentist, I hate to admit that keeping up with my twice-yearly routine dental appointments fell by the wayside for a while. When I finally got back into a routine (three years later), my teeth were pretty bad and needed a lot of fillings. The upside was that, by that time, I had found a low-carb way of eating which put a lot less sugar into my body and into my teeth.

It’s very typical for diabetics to have more dental problems than non-diabetics. You may have less saliva, causing your mouth to feel dry. Because saliva protects your teeth, you’re also at a higher risk of cavities. Gums may become inflamed and bleed often (gingivitis). You may have problems tasting food, and you may be susceptible to infections inside your mouth.

The most common ailment is periodontal disease. This chronic, inflammatory disease can destroy your gums, all the tissues holding your teeth, and even your bones. High blood sugar may also cause dry mouth and make gum disease worse. Less saliva can allow more tooth-decaying bacteria and plaque buildup. Not only does poor blood sugar control cause gum disease, but the disease itself can cause blood sugar to rise even further. Diabetes can slow down healing, so it can interfere with treatment of periodontal disease.

As an aside, you might like to know that researchers have found increased dementia risk in persons with severe gum disease. Since dementia is often referred to as type 3 diabetes, this is significant.

Of course, you should be even more diligent than ever about oral hygiene at home. One procedure that isn’t mentioned much is using mouthwash after brushing. Does mouthwash work? The experts say, yes, “a short 30-second mouthwash investment can result in a clear reduction in dental issues such as plaque and gingivitis.” Many years ago, I had a dentist who recommended that I use LISTERINE® after brushing. Turns out that current research shows that antimicrobial LISTERINE® mouthwash kills oral bacteria within 30 seconds “for a difference you will notice with continued use.” So, instead of using LISTERINE® to soak your feet, use it as a mouthwash after brushing your teeth!

However, along with consistent oral hygiene, the best way that you can prevent diabetes-related complications in your dental health is to maintain optimal control over your blood sugar levels.

Dental Care For Diabetics – Dr. Bernstein’s Diabetes University

10-minute video

References

“Diabetes & Oral Health,” National Institute of Dental and Craniofacial Research (last reviewed July 2018). https://www.nidcr.nih.gov/health-info/diabetes (accessed on 7/23/2020).

“Does mouthwash work?” National Dental Care, n.d. https://www.nationaldentalcare.com.au/does-mouthwash-work/ (accessed on 2/20/2020).

Domina, Diane. “From Your Mouth to Your Brain: The Gum Disease-Dementia Link,” Health Central (March 18, 2019). https://www.healthcentral.com/article/from-your-mouth-to-your-brain-the-gum-disease-dementia-link?ic=6107& (accessed on 7/23/2020).

Jovinelly, Joann, and Rachel Nall, RN, BSN; medically reviewed by George Krucik, MD, MBA. “Type 2 Diabetes and Oral Health,” Healthline (updated March 15, 2017). https://www.healthline.com/health/type-2-diabetes/oral-health#prevention (accessed on 7/23/2020).

Martin, Laura, Case Western Reserve University School of Dental Medicine. “Diabetes and Your Smile,” Mouth Healthy, n.d. https://www.mouthhealthy.org/en/az-topics/d/diabetes (accessed on 7/23/2020).

Newman, Tim; fact checked by Jasmin Collier. “What’s the link between vitamin D, gum health, and diabetes?” Medical News Today (August 22, 2018). https://www.medicalnewstoday.com/articles/322830.php (accessed on 7/23/2020).
“We know that vitamin D is not only helpful for bone health,” Aleksandra Zuk notes, “but is also shown to have antimicrobial and anti-inflammatory effects. Sufficient vitamin D levels can potentially decrease inflammation and affect oral microbes related to gum disease.”

WebMD Medical Reference; reviewed by Michael Dansinger, MD. “Dental Problems and Diabetes,” WebMD (December 1, 2019). https://www.webmd.com/diabetes/dental-problems (accessed on 7/23/2020),

“Why Rinse? The Power of Antimicrobial Mouthwash,”  LISTERINE®, n.d. https://www.listerine.com/mouth-coach/why-rinse-for-oral-health (Accessed on 7/23/2020).