Attention Diabetics in Phoenix and Scottsdale...

If you are a diabetic you know the importance of controlling your blood sugar, proper diet and all around good health. Taking care of your mouth, teeth and gums and maintaining a healthy oral care regime will help you avoid gum tissue damage, bone density lose and the eventual loss of teeth.

Tell your dentist you have diabetes and ask him or her to show you how to keep your teeth and gums healthy. People with diabetes get gum disease more often that people who don’t have diabetes. Gum infections can make it hard to control blood sugar. Once a gum disease starts, it can take a long time to heal. If the infection is severe, teeth can loosen or even fall out. Good blood sugar control can prevent problems with your gums.

Diabetes can affect the entire body. Whether your diabetes affects your oral health depends on how well you are able you are to control your blood sugar. If your diabetes is under control, the effects on your oral health should be minimized. However, if your diabetes is not under control, the oral effects can be dramatic.

People with diabetes can have:

• Rapidly progressing periodontal (gum) disease
• Gum inflammation (gingivitis)
• Dry Mouth (xerostomia)
• Poor healing of oral tissues
• Oral thrush (candidiasis)
• Burning mouth and or tongue

Uncontrolled diabetes impairs white blood cells called neutrophilis, which are a main defence against bacterial infection. Because periodonatal disease is a bacterial infection, people with uncontrolled diabetes are more likely to have it, and their conditions are likely to be more severe.

Successfully treating severe periodontal disease can improve diabetic control because any type of infection may cause blood sugar levels to rise which increases the need for insulin. If the infection is treated successfully, the need for insulin may decrease and diabetic control will likely be easier.

Dry Mouth (xerostomia) can increase your risk of tooth decay because saliva normally washes away sugars and food particles that are the fuels of decay-causing bacteria. Recent studies have shown that uncontrolled diabetics have decreased salivary flow. However, there is no widespread agreement on whether diabetics as a group have more or less tooth decay than non-diabetics. If you have a dry mouth, practice regular oral hygiene to prevent decay. You may want to talk to your dentist or physician about artificial saliva, or other means of reducing your dry mouth. Fluoride rinses or gels should be used to reduce the possible increase the decay rate.

If you have uncontrolled diabetes, you may have problems healing quickly after oral surgery or other dental treatments because blood flow to the site can be impaired.

You may also be at risk of fungal infection called thrush, or oral candidiasis, which thrives on the sugar in your saliva. Antifungal medication is the treatment for this condition. Oral candidiasis can cause a burning sensation in your mouth, sometimes called burning-mouth syndrome or stomatodynia. The syndrome has other causes as well, but antifungal medication may help if it is caused by oral candidiasis.

If you are a diabetic and would like to know more about your condition and how it relates to oral health, please call our office for an appointment. We are here to help you with all your oral care needs.

No matter how well controlled your diabetes is, it’s important to keep your dentist informed about your condition. Your dentist should become a part of your health care team and know about any changes in medication or the status of your condition. Anything that you can tell your dentist about your condition will help him or her decide what the best treatment will be for you. At the very least, your dentist your dentist should have your physicians name and phone number so he or she can contact your physician with any concerns or questions.

Your dentist may want to know your glycosylated haemoglobin level (the result of your haemoglobin A1C test) to get an idea of how controlled you diabetes is. The test show percent of your haemoglobin that is glycosylated (has sugar attached to it). Diabetics should aim for less than 7 percent. Higher levels can indicate poor diabetic control, meaning there is more sugar in the blood than there should be.

If your diabetes is well controlled, you probably do not need any special dental care. However, uncontrolled diabetics, especially those with cardiovascular and/or kidney problems should receive antibiotics before and after any dental treatment, such as surgery, that might put them at risk for bacterial infection.

Take your insulin and eat normally before going to the dentist; continue to do what’s normal for you. Your dentist may have a source of glucose, such as juice in case of hypoglycaemia (low blood sugar; also know as an insulin reaction). However, you should take a source of glucose with you to make sure you have it if you need it. Glucose tablets, available at pharmacies, are convenient to carry, but crackers, cookies or any other form of carbohydrates will do. After treatment, resume your normal diet immediately. If this is not possible, seek advice from your doctor.

Some recent changes in the case of diabetes may affect your visit to the dentist. The cut-off blood-sugar level for the control of diabetes, which used to be 140g/dl, is now 126 g/dl. This increases the chance of hypoglycemic episodes.

If you’ve had a hypoglycaemic episode in the past you are at increased risk to have another one. Tell your dentist if you have had an episode, when the last one was and how common they are. Most hypoglycaemic problems will occur when your insulin peaks, so make sure your dentist knows when you last took insulin.

Some medications your dentist might use can interfere with some oral medications you may be taking for your diabetes. This makes it even more important that the dentist know the medication that you are taking and their doses.

Follow your dentist post treatment instructions thoroughly. People with diabetes tend to be slower to heal and more prone to infection, so do whatever you can to help yourself recover completely. Also, it is especially important for diabetics who are having diabetics who are having orthodontic work done to contact their orthodontist immediately if a wire or bracket is cutting into their tongue or mouth so it can be fixed before a sore forms. People with intraoral appliances made of acrylic may also have an increased risk for candidiasis.

If your dentist has successfully treated a major infection, you may need to visit your physician to have your insulin dose calibrated.

If you are a diabetic and would like to know more about your condition and how it relates to oral health, please call our office for an appointment. We are here to help you with all your oral care needs.

Every year millions of Americans are affected by diabetes. If you have been diagnosed with diabetes you may know that the disease causes many problem with your heart, kidney, eyes and nerves as well as other parts of your body including your feet and toes. Diabetes can lower your resistance to infection and can slow down the healing process.

The most common oral care problems diabetics face are:

• Tooth decay
• Periodontal (gum) diseaseae
• Salivary gland disfunction
• Fungal infections
• Lichen planus and lichenoid reactions (inflammatory skin disease)
• Infections and delayed healing
• Taste impairment

Makes sure your medical records are up to date and let the dentist know the following

• If you have been diagnosed with diabetes
• If the disease is under control
• If there has been any other change in your medical history
• The names of all the drugs you are taking including OTC medicatation

When diabetes is not controlled properly, high glucose levels in saliva may help bacteria thrive. Brushing twice a day with fluoride toothpaste and cleaning once a day between your teeth with floss or an interdental cleaner helps remove decay causing plaque.

Plaque that is not removed from the teeth can eventually harder (calcify) into calculus or tartar. When tartar collects above the gumline, it becomes more difficult to brush and clean between teeth. This can create conditions that lead to chronic inflammation and infection in the mouth.

Because diabetes reduces the body’s resistance to infection, the gums are among the tissues likely to be affected. Periodontal diseases are infections of the gum and bone that hold your teeth in place.

Periodontal disease often is linked to the control of diabetes. For example, patients with inadequate blood sugar control appear to develop periodontal disease more often and more severely, and they lose more teeth than do people that have good control of their diabetes.

See your dentist now if you notice any of the following:

• Gums that bleed easily
• Red, swollen or tender gums
• Gums that have pulled away from the teeth
• Pus between the teeth and gums when the gums are pressed
• Persistent bad breath or bad taste in the mouth
• Permanent teeth that are loose or separating
• Any change in the way your teeth fit together when you bite
• Any change in the fit of partial dentures