Oral Health and Diabetes: Tips for a Healthy Smile


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Oral Health and Diabetes: Tips for a Healthy Smile[1]

 

Having diabetes can impact your oral health, increasing your risk of gingivitis (early gum disease) and periodontitis (advanced gum disease that can lead to tooth loss). Fortunately, by practicing good oral care and managing your diabetes, you can prevent problems with your teeth and gums. In fact, simple routine changes like using LISTERINE® Cool Mint Antiseptic Mouthwash twice a day have been shown to reduce symptoms of early gum disease in people with controlled diabetes.1

The link between diabetes and oral health complications

One of the hallmarks of diabetes is high blood sugar (called hyperglycemia), which can leave mouths vulnerable to periodontal diseases. Chronic high blood sugar levels make it more likely that you’ll develop oral health problems[2], including periodontal (gum) disease[3], dry mouth, burning, and thrush (a fungal infection). Indeed, sugar is food for bacteria, and mouths with excessive sugar provide the ideal environment for bacteria to grow. 

What’s more, uncontrolled diabetes is associated with weakened white blood cells, which are important defenders against bacteria. Elevated levels of sugar in the bloodstream also lead to inflammation[4], which causes blood vessels to thicken. Thickened blood vessels can slow down the flow of nutrients to our body tissues, including those in our mouth. 

Both type 1 and type 2 diabetes are major risk factors for periodontitis[5], and according to the U.S. National Health and Nutrition Examination Survey (NHANES) III, adults with an A1C level (a measure of blood sugar control over the previous two to three months) of greater than 9% had a significantly higher prevalence of severe periodontitis than adults without diabetes. The American Dental Association estimates that periodontal disease[6] affects nearly 22% of those diagnosed with diabetes. 

Why does this happen? Glucose (sugar) is found in the saliva. High glucose levels can cause the growth of harmful bacteria that, when combined with food, can form a sticky film called plaque. If not treated, plaque can harden into tartar and eventually lead to gum disease. In addition, uncontrolled diabetes can weaken the immune system, lowering your resistance to infection and making oral health problems more severe.

Common oral health issues in people with diabetes

The most common oral health problems in people with diabetes include:

Gingivitis

An early stage of gum disease. Symptoms include red, swollen and bleeding gums.

Periodontitis

An infection that damages the soft tissue and bone that support teeth. Signs include red, swollen and bleeding gums; gums that pull away from teeth; bad breath; teeth that are loose or that move away; and tooth loss.

Xerostomia (dry mouth)

Dryness in the mouth caused by a lack of saliva, raising the risk of tooth decay and gum disease. Symptoms include a dry feeling in the mouth; a dry, rough tongue; mouth sores; cracked lips; and problems chewing, eating, swallowing or talking.

Oral burning

A burning sensation in the mouth which may be caused by thrush or fungal growth. Symptoms include burning in the mouth; dry mouth; or a bitter taste in the mouth.

Thrush

A fungal (yeast) infection that occurs in the mouth that can be caused by high blood sugar levels. Symptoms include white patches on the inner cheeks, tongue, roof of the mouth and throat; redness and soreness in the mouth; loss of taste; pain with eating or swallowing; and cracking and redness at the corners of the mouth. Wearing dentures increases the risk of this condition. Additionally, those with uncontrolled diabetes who smoke cigarettes are also at increased risk.

Poor healing

As mentioned above, uncontrolled diabetes can compromise blood flow, and blood flow is necessary for adequate healing. If oral sores or lesions develop in the mouth, these may be slower to heal because of the decreased blood flow to that area.

Tips for improving and protecting your oral health

Oral health problems can be serious, but there are many steps that you can take to prevent them and ensure that your mouth, teeth and gums stay healthy.

Develop an oral-care routine that includes LISTERINE Cool Mint Antiseptic Mouthwash.

For people with controlled diabetes, it is important to incorporate good oral health care into their routines, because it has been proven that diabetes can impact gum health. A study conducted by LISTERINE found that using LISTERINE Cool Mint Antiseptic Mouthwash twice daily helps to prevent and reduce plaque and gingivitis in people with controlled diabetes. Using LISTERINE Cool Mint can help maintain healthy gums and improve oral health.1

Brush your teeth twice a day.

In addition to rinsing with LISTERINE Cool Mint Antiseptic Mouthwash twice daily, use a soft-bristled toothbrush and choose a toothpaste that contains fluoride. Consider using an electric toothbrush, as electric toothbrushes reduce more plaque and gingivitis than manual toothbrushes.

Floss daily.

Flossing helps to remove food particles, bacteria and plaque and can prevent cavities and gum disease. I make a habit of carrying floss in my purse to use after lunch.

Get and keep your blood sugar at a safe level.

Counting carbs, staying active, taking your diabetes medicines as prescribed, and checking your blood sugars are ways to help you manage your diabetes. I always advise my patients to avoid simple carbs, which tend to raise blood sugar levels. Simple carbs include many things, but an easy-to-remember rule is avoid the white stuff, including white rice, white potatoes, white noodles, white bread and so forth.

See your primary care doctor regularly.

Remember that oral health is related to how well-managed your diabetes is. See your primary care provider regularly. I recommend every three months, so that blood sugar levels can be evaluated, and medications can be adjusted as needed.

Visit your dentist at least twice a year.

Keep up with twice-yearly dental appointments for cleanings, checkups and X-rays. Remember to tell your dentist that you have diabetes.

Quit smoking.

Smoking doubles your risk of gum disease[7], which is also more difficult to treat in smokers. 

Let your dentist know right away if you have red and swollen or bleeding gums, loose teeth, a change in how your bite feels or bad breath.

1Shown in a clinical study, vs. brushing alone in people with controlled diabetes. Intended to treat early gum disease

Endnotes:
  1. [Image]: https://cdn.diabetesselfmanagement.com/2021/01/Screen-Shot-2021-01-27-at-3.10.54-PM.png
  2. develop oral health problems: https://my.clevelandclinic.org/health/diseases/11263-oral-health-problems-and-diabetes
  3. periodontal (gum) disease: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/gum-disease-dental-problems
  4. lead to inflammation: https://vascular.org/news-advocacy/why-diabetes-can-damage-your-blood-vessels-and-how-know-if-you’re-risk
  5. major risk factors for periodontitis: https://pubmed.ncbi.nlm.nih.gov/12000341/
  6. periodontal disease: https://www.mouthhealthy.org/en/az-topics/d/diabetes#:~:text=Periodontal%20disease%20is%20the%20most,the%20risk%20for%20gum%20problems.
  7. doubles your risk of gum disease: https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html#:~:text=You%20have%20twice%20the%20risk%20for%20gum%20disease%20compared%20with%20a%20nonsmoker.&text=The%20more%20cigarettes%20you%20smoke,your%20risk%20for%20gum%20disease.&

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