Diabetics & Dental Treatment

Dr. Sonia Sharma

Question: I am a middle aged diabetic patient with dry mouth, swollen and bleeding gums. Are these problems common among diabetic patients? What should I do to get rid of this difficulty?  Yashwant Rooprai, Mississauga

Dr. Sharma: The most common problem affecting gums and teeth for people with diabetes is gum disease. But diabetes can increase your risk of other mouth problems as well, including oral infections, fungal infections, poor healing and dry mouth. Controlling your blood sugar is sometimes difficult when coupled with mouth problems, but it’s key to recovery.

An oral infection is commonly a cluster of germs causing problems in one area of your mouth. Here are some warning signs:

• Swelling or pus in your mouth, especially around your teeth or gums
• Pain in your mouth or sinus area that won’t go away
• Pain when chewing
• Teeth that hurt when you drink something cold or hot, or when you chew
• Dark spots on or holes in your teeth

Infections can make your blood sugar hard to control. Plan ahead by discussing a plan of action with your dentist or doctor just in case you develop an infection. You’ll be prepared to handle needed adjustments.

Being diabetic, also more prone to fungal infections, such as oral thrush. If you tend to have high blood sugar levels or take antibiotics often, you’re even more likely to have this problem. Signs of thrush include red or white patches in your mouth. These can become painful or develop into ulcers.

Thrush likes to form in moist spots that may be chafed or sore, such as under poorly fitting dentures. If you smoke and wear dentures both day and night, you’re at increased risk of thrush. You can reduce your risk by quitting smoking and wearing dentures only during the day. If you think you have a fungal infection, talk to your dentist or doctor.

If your diabetes is poorly controlled, you heal more slowly and increase your risk of infection after dental surgery. To reduce your risk of infection and speed healing, control your blood sugar before, during and after surgery.

Most often, people with diabetes complain of dry mouth. Dry mouth has multiple causes. It can be a side effect of a medication or the result of persistently elevated blood sugar. Dry mouth can increase your risk of cavities because you have less saliva to wash away germs and take care of the acids they create. It can also lead to salivary gland infections.

Lack of saliva is a common problem that may seem little more than a nuisance. But don’t ignore it. Persistent dry mouth can affect how your food tastes and may even affect the health of your teeth. Although the treatment depends on the cause, dry mouth is often a side effect of medication.

The saliva in your mouth serves many purposes. Most noticeably, saliva makes it easier to talk. Saliva also helps prevent tooth decay. It washes away food and plaque from your teeth. Minerals found in saliva help repair early tooth decay. Saliva also limits bacterial growth that can dissolve tooth enamel or lead to mouth infections. And saliva neutralizes damaging acids in your mouth. Saliva enhances your ability to taste your food and makes it easier to swallow. In addition, enzymes in saliva aid in digestion.

On any given day, a healthy adult produces about 3 pints of saliva. Still, saliva generally goes unnoticed unless you don’t produce enough. In that case, the result is xerostomia (zeer-o-STO-me-uh) — the medical term for dry mouth.

Since you have dry mouth, try drinking more fluids. You can also try chewing sugar-free gum or eating sugar-free candy to help keep the saliva flowing. Some people use saliva substitutes, available at drugstores.

Because diabetes makes you more prone to gum disease and other mouth problems, schedule regular dental appointments to identify potential problems. Talk to your dentist about what frequency is appropriate for you.

Please remember that the information is provided as general information. It is NOT intended to replace professional care. Since every patient and every case may vary, consult your physician or dentist for advice on your particular situation.

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