Diabetes Self-Management Articles

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Keeping Your Mouth Squeaky Clean
New Products That Can Help

by Shirley Gutkowski, RDH, BSDH

Periodontal (gum) disease has been called the sixth complication of diabetes (in addition to eye, kidney, nerve, foot, and cardiovascular complications) because so many people with diabetes have it. Having high blood glucose raises the risk of developing periodontal disease, and periodontal disease tends to raise blood glucose levels. So clearly, making an effort to brush, floss, and have regular dental checkups is important when you have diabetes.

However, sometimes these efforts just don’t seem to be enough, and a little more help is needed. This is particularly true when a person has dry mouth, or a lower-than-normal amount of saliva. Normally, saliva protects the teeth and gums by diluting the acids that are excreted by bacteria in the mouth and that are also present in foods and beverages. Saliva additionally contains minerals such as calcium, phosphate, and fluoride that are necessary for rebuilding the teeth and keeping the enamel strong. It also helps you chew and swallow food. When there is not enough saliva to perform these functions, a person’s risk of tooth decay, gum disease, and other mouth infections rises.

There are many causes of dry mouth — some avoidable, and some not. Dry mouth is a common side effect of many prescription and nonprescription drugs. It is a symptom or side effect of numerous medical conditions, including diabetes. It can be a side effect of some medical treatments, such as radiation for cancer treatment. It can also be caused by dehydration, smoking or chewing tobacco, or prolonged breathing through your mouth.

While many people are well aware that they have dry mouth, not everyone who has it notices it. However, if you cannot eat a cracker without drinking water, or if your dentist or dental hygienist tells you you have dry mouth, you are at the same heightened risk of tooth decay as someone who is bothered by the dryness.

There are some time-tested home remedies for dry mouth, including sipping water or sugarless drinks throughout the day, chewing sugar-free gum, and using a humidifier at night. It may also help to avoid alcohol, tobacco, and drinks containing caffeine, which can dry out the mouth even more.

In recent years, researchers have developed a number of products to help increase the amount of saliva in the mouth and to counteract the negative effects of not having enough. This article describes some of the newer products to come onto the market, as well as some others still in development. While many are aimed primarily at consumers with dry mouth, they can all be used by anyone who wishes to step up their home dental care and lower their risk of tooth decay and gum disease.

Sucking on a piece of hard candy can cause you to secrete more saliva and make your mouth feel moister, but sucking on candy sweetened with sugar or most other caloric sweeteners increases the amount of acid in your mouth and raises your risk of tooth decay.

A better option, and one that may actually improve your oral health, is to suck on candy or to chew gum sweetened solely or primarily with xylitol. Xylitol is a type of sugar alcohol that has a minimal effect on blood glucose level. (Sugar alcohols are a type of carbohydrate that are incompletely broken down and absorbed by the body. They contain neither sucrose nor alcohol.) While ingesting too much xylitol can cause diarrhea, regular use of products containing it has been shown to decrease plaque buildup on teeth, which should lower the risk of periodontal disease. Xylitol has also been shown to increase collagen formation, which means it has the potential to strengthen the fibers that hold teeth in place. And a recent study in rats additionally showed that rats that drank water with xylitol in it had increased bone density, making xylitol a potential candidate for the treatment of osteoporosis (weak, porous bones that are prone to fracture).

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