Recently, a patient came into my office with a severe infection from an abscessed tooth. We treated the situation aggressively because they were experiencing a great deal of pain. I was further concerned because the patient has diabetes.
Diabetes is a condition that affects how food is metabolized. Hormones in our bodies control how much glucose (or sugar) is present in our bloodstream for our cells to use for energy. When blood sugar goes up, the pancreas releases insulin, which allows the body to absorb the sugar into the cells. With diabetes, the pancreas does not release sufficient amounts of insulin, or the body doesn’t respond to insulin as it should. In either case, too much glucose remains in the blood, which can cause serious health problems, including heart disease, vision loss, kidney disease, and poor circulation.
It also has serious oral implications. High blood sugar weakens white blood cells, which are responsible for fighting bacterial infections. Gum (or periodontal) disease and tooth decay are both bacterial infections. In periodontal disease, the bacteria attack the bone and attachment apparatus between the tooth and the bone.
Cavities are caused by the acids that bacteria secrete, which eat away at the tooth structure. Diabetics have the added complication of higher levels of sugar in their saliva, which fuels the pathological bacteria in their mouths and causes disease processes to be more active.
Nine out of ten cases of diabetes are Type 2. While there is a genetic predisposition to developing Type 2 diabetes, onset of the disease can be attributed to five key factors: excess body fat, diet high in refined carbohydrates, physical inactivity, smoking, and alcohol consumption. Managing those aspects of your life can greatly reduce your risk of developing the disease. Studies show that about one in eight Americans have diabetes, and another concerning statistic is that one in four adults in the U.S. with diabetes do not know they have the disease.
Signs of diabetes that you should not ignore include: peeing more often than normal, feeling thirsty all the time, weakness and fatigue, blurry vision, increased hunger (even after just eating), and unexplained weight loss.
In the case of my patient above, we extracted the tooth, prescribed an antibiotic, and closely monitored their recovery. For all my patients with diabetes, I encourage great home care: brushing with an electric toothbrush, flossing, and using a water pik are all super important. I also recommend that they come in three to four times a year for a professional cleaning. Hygienists are able to remove hard bacterial plaques that accumulate at the gum line and cannot be removed with brushing and flossing. The latest research shows that these plaques reach a pathological level after about ninety days, regardless of home care. More frequent visits are also helpful for detecting problems early on, which allows me to provide less invasive and longer-lasting treatments.
Diabetes weakens the body’s ability to fight infection, making oral diseases like gum infection and tooth decay more severe and harder to control. With proper lifestyle management, consistent home care, and more frequent dental visits, patients with diabetes can greatly reduce their risk of serious oral and systemic complications.
Health and Fitness
ABOUT THE AUTHOR: Dr William Plumb graduated from the State University of New York School of Dentistry in 2006. He opened Plumb Dental in St George in 2009. He has received extensive continuing education in cosmetic dentistry as well as oral surgery and implantology. He loves living in Southern Utah with his wife Kari and their four children.