Diabetes is a diagnosis not restricted to adults. With childhood obesity on the rise, there are more and more children being diagnosed with diabetes. Diabetes can affect your mouth in many ways. The increase in glucose or sugar in your blood can cause pain, infection or other problems in your teeth, gums, jaw and other tissues (tongue, inside of cheeks and roof and bottom of your mouth). There is more glucose in your saliva when diabetes is not controlled and these extra sugars can cause bacteria to grow faster. The overgrown bacteria, combined with the food you eat, forms plaques which are sticky and hard to scrub off from your teeth. Not only does the plaque lead to gum disease and cavities, it can contribute to bad breath.
Gingivitis – inflamed, red, swollen, bleeding gums
Periodontitis (advanced gingivitis) – infection causing gum and also the supporting bone to pull away from the teeth – eventually may lead to tooth loss
Thrush – uncontrolled fungal growth, white sore patchy mucous membranes, open sores
Xerostomia (dry mouth) – dry, rough mucous membranes leading to problems with eating, swallowing or talking, pain in mouth, cracked lips, sores which are hard to heal
If you have diabetes, check your mouth for signs of these problems and speak to your dentist right away if you notice any of the above conditions. The best option is to see your dentist at least twice a year for a cleaning and checkup because it is very difficult to notice the first signs and symptoms and the damage may have progressed by the time you do notice.
Research has suggested that the relationship between diabetes and periodontal disease goes both ways – periodontal disease may make it more difficult for people who have diabetes to control their blood sugar. Severe periodontal disease can increase blood sugar, contributing to increased periods of time when the body functions with a high blood sugar. This puts people with diabetes at increased risk for diabetic complications.
-monitor your blood glucose and keep it as close to target as possible
-eat healthy meals and follow a meal plan
-brush your teeth at least twice a day with fluoride toothpaste – aim for morning, before bed and after each meal or sugary/starchy snack
-talk to your dentist about using a fluoride mouth rinse or anti-plaque/anti-gingivitis mouth rinse/saliva substitute if you have dry mouth
-get a soft toothbrush, gently brush with it angled towards the gum line with small circular motions
-tell your dentist about any changes in your health or medications, share the results of your diabetes blood tests such as A1C or fasting blood glucose test and ask if you need antibiotics before or after any dental treatment if diabetes is uncontrolled
Dr. Phoebe Tsang is a Fellow of the Royal College of Dentists of Canada (F.R.C.D.) in Pediatric Dentistry and a licensed Certified Specialist in Pediatric Dentistry in BC. The Royal College of Dentists of Canada is an organization which ensures high standards of specialization in the dental profession and recognizes properly trained dental specialists through comprehensive qualifying exams. Visit Dr. Tsang at the Children's Oral Care Centre in Abbotsford, BC.
Outside of the office, Dr. Tsang is a clinical assistant professor of Faculty of Dentistry who is actively engaged in teaching dental students at the University of British Columbia and general practice residents at Vancouver General Hospital and British Columbia's Children's Hospital.
Read Dr. Tsang's blog here.