According to the American Diabetes Association, nearly 24 million people have diabetes. Of that number, unfortunately, 5.7 million people are unaware that they have the disease. Diabetes can affect multiple parts of the body, including the kidneys, nerves, heart and even the mouth (see also <http://www.newsrx.com/library/topics/Diabetes.html> Diabetes).

Because diabetics are more prone to several oral health problems, including tooth decay, periodontal (gum) disease, salivary gland dysfunction and infection, the Pennsylvania Dental Association (PDA) reminds diabetic patients of the importance of maintaining optimal dental health.

It is important to let your dentist know if you suffer from diabetes and if the disease is under control.

“At each dental visit tell your dentist about the status of your diabetes,” said Dr. Bruce Terry, a PDA member and endodontist from Wayne. “Let the dentist know your most recent glycosylated hemoglobin (HgA1C) level to determine how well your diabetes is controlled. A good value should be under 7 percent. Inform your dentist of any recent hypo or hyperglycemic episodes. Uncontrolled diabetics are at higher risk for complications from local anesthetics (lidocaine) as well as complications with oral surgery and even simple tooth cleanings. If you take insulin, tell your dentist when you normally take insulin and when your last dose was taken.”

Diabetic patients are at greater risk for tooth decay due to the presence of higher bacteria levels found in saliva when diabetes is not under control. As diabetes can lower resistance to infection, periodontal disease can develop.

Brushing twice a day and flossing daily will help remove plaque, the sticky film of bacteria that causes tooth decay and periodontal disease. Using fluoride toothpaste and an antibacterial mouthrinse is another way to help fight tooth decay.

It is imperative to visit the dentist at least twice a year for routine checkups and professional cleanings. The dentist may recommend more frequent checkups and cleanings for diabetic patients. Though brushing and flossing removes some plaque, it can’t remove it all. If plaque isn’t removed, it hardens to form tartar, which can lead to chronic inflammation and infection in the mouth.

Diabetic patients should contact their dentist immediately if they observe any of the warning signs of periodontal disease, including, red, swollen or tender gums or gums that bleed easily or are pulling away from the teeth; chronic bad breath or a bad taste in the mouth; teeth that are loose or separating; pus appearing between the teeth and gums when the gums are pressed; or changes in the alignment of the teeth.

Diabetic patients often suffer from dry mouth (xerostomia), which greatly increases their risk of tooth decay and periodontal disease. Talk with your dentist if you are experiencing dry mouth. He or she may recommend a saliva substitute, as well as fluoride treatment to prevent tooth decay. Chewing sugarless gum or mints, drinking water or sucking on ice chips may help to ease the discomfort of dry mouth.

Bacteria, viruses and fungi occur naturally in the mouth. Oral candidiasis, a fungal infection in the mouth, appears to occur more frequently among people with diabetes, including those who wear dentures. If a diabetic patient smokes, has high blood glucose levels or takes antibiotics, he or she is more likely to have a problem with a fungal infection of the mouth.

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