The mouth has been called a mirror of health, and a healthy mouth is indeed a pleasant sight to see in the mirror. It is not news to anyone that proper nutrition is an important component of overall health and well-being, but you may not know that food choices affect oral health in more ways than just preventing cavities. Learning how to use the power of good nutrition is particularly important for people with diabetes, since diabetes of any kind has been associated with a higher risk of oral health problems.
The oral complications of diabetes can range in severity from annoying to dangerous. The most common complications are periodontal disease, including gingivitis (inflammation and infection of the soft gum tissue) and periodontitis (inflammation and infection of the supporting ligaments and bones of the teeth); oral candidiasis (yeast infection); cavities (known to dentists as caries); xerostomia (dry mouth); burning mouth syndrome; and impaired taste function. As with other complications of diabetes, tight blood glucose control is imperative in the prevention and control of oral problems. Of course, proper oral hygiene and regular dentist visits are also important. In addition, there are some simple nutrition practices that may help guard against the development and progression of oral health complications.
Periodontal disease has been called the “sixth complication” of diabetes because of the link between the two diseases. Having periodontal disease may increase the risk of death from ischemic heart disease (in which blood flow, and therefore oxygen, is restricted to the heart) or nephropathy (damage to the kidneys). Because people with diabetes have a high risk of developing periodontal disease, awareness of the risks, symptoms, and preventive measures is important.
Periodontal disease is a chronic disease that involves the gums and bone structure of the mouth. Gingivitis is the precursor to periodontitis and is characterized by spaces, or pockets, developing between the teeth and gums. Plaque, a sticky film of bacteria, inhabits these pockets, promoting the growth of more bacteria and gradually destroying the gums and a type of bone in the mouth called alveolar bone, which anchors the teeth in place. Left untreated, periodontitis can lead to tooth loss.
Periodontal disease results in chronic inflammation of tissues in the mouth. Similarly, both diabetes and cardiovascular disease are associated with inflammation. Since these conditions are all linked to inflammation, it should be no surprise that they are linked to one another, as well. In fact, not only is diabetes a risk factor for periodontal disease, but periodontal disease has been marked as a risk factor for developing diabetes. Moreover, periodontitis seems to negatively affect blood glucose control. Other risk factors for periodontal disease include smoking, hormonal changes (such as occur in adolescence, pregnancy, and menopause), genetics, poor dental hygiene, and poor nutrition.
While it is still not entirely understood why people with diabetes are at increased risk for periodontitis, there are some plausible theories. One is that the immune system may function somewhat abnormally in people with diabetes; this would both decrease the ability of the body to fight bacterial invasion and increase inflammation in the mouth. Inflammation in the mouth may also be partially attributed to the increase in harmful blood lipids (triglycerides and LDL [“bad”] cholesterol) common to diabetes. People with diabetes additionally have a decreased ability to produce collagen, a protein that provides strength and elasticity in the cells, hindering the healing of wounds in the mouth. Lastly, chronic high blood glucose leads to both increased glucose availability for oral bacteria to thrive upon and the destruction of oral tissues due to oxidation (a process of breaking down).