Published on Dec 27, 2018 and last reviewed on Aug 01, 2023 - 4 min read
Abstract
This article emphasizes the impact of diabetes mellitus on oral health problems and its management.
Introduction:
Diabetes mellitus is a metabolic disorder which affects the uptake and use of glucose by the human body. As a result, the glucose level in the blood rises beyond normal which has an overall impact on the general health and oral cavity. Diabetes that is poorly managed can weaken the white blood cells. White blood cells are the major defense mechanisms in the body and they act against any infection that enter the body. People with diabetes are at a greater risk of suffering from dry mouth, gum inflammation, poor healing of oral tissues, burning mouth or tongue, and so on.
Insulin-dependent diabetes mellitus: It occurs due to deficiency of insulin hormone from the pancreatic cells. As a result, the glucose level in the blood rises which is not taken up by the liver cells.
Oral Manifestations:
There are several oral manifestations of diabetes mellitus. These are:
First, ask the patient for fresh tests like fasting blood glucose level and postprandial level.
Ask the patient for CBC (complete blood count) and CTBT (clotting time and bleeding time) to avoid complications from bleeding.
Before a major surgery, ask the patient to take the consent of an endocrinologist as well.
If these tests are normal, then go for extraction and if these are not normal, send the patient to the endocrinologist for management till investigations return to normal.
Ideally, the dentist should ask the patient to bring fasting blood glucose report and monitor postprandial level before extraction. After extraction, the postprandial test should be repeated after two hours. It is always better to keep the patient on monitoring for two hours after surgery or extraction.
Ideally, it is better and safer to do an extraction after the patient has taken food because one can compromise with hyperglycemia but not with hypoglycemia.
Between fasting glucose level of 110 to 125 mg/dl, one can do the extraction and less than 140 mg/dl after measuring postprandial levels.
If the patient has well-controlled diabetes, oral hypoglycemic drugs can be stopped for 24 hours prior to extraction or minor surgery. But glucose levels need to be monitored pre and postoperatively for two hours until the patient eats again and medication is to be started again.
However, if the disease is poorly controlled, the patient may require insulin before surgery. For such cases, the consent of an endocrinologist must be taken.
Conclusion:
It is important for any diabetic patient to follow the preventive measures and maintain a good oral health. If one have sufficient technical and manpower support, then they can go for extraction. But, if one has problems of poor infrastructure, it is always wise to send the patient to an established government or private hospital. If the patient has poor diabetic control, one must never hesitate in referring the patient to an endocrinologist.
Every other individual is affected by diabetes. Diabetes causes increased sugar levels which cause poor wound healing. In addition, it increases the risk of tooth decay and tooth mobility. Hence diabetic patients need to visit their dentist once in six months to undergo scaling and identify dental problems at an earlier stage.
Diabetes increases the level of sugar in saliva. This helps the oral bacteria to multiply and cause tooth decay rapidly. In addition, it increases the risk of tooth loss and helps to adhere food particles to the tooth surface due to the sticky saliva.
Periodontitis is the sixth major symptom in patients with diabetes. Periodontitis refers to the inflammation and infection of the tissues supporting the tooth and covering the bone. Severe periodontitis results in tooth mobility, eventually resulting in tooth loss.
Diabetes increases the risk of tooth loss in patients with poor oral hygiene. Hence diabetic patients have to pay extra attention to their teeth and visit dentists regularly for a thorough cleaning and dental check-up. In addition, using dental floss and mouthwash can prevent the risk of caries susceptibility.
Dryness of mouth, also called xerostomia, is associated with diabetic patients. Individuals with high glucose levels are more prone to mouth dryness. Artificial saliva and consumption of citrus fruits are advised in patients with dry mouths to induce salivary secretion.
The following are the risk factors of diabetes:
- Family history of diabetes.
- Prediabetes.
- Obesity.
- Lack of physical activity.
- Gestational diabetes.
Diabetes causes mouth dryness which results in ulcer formation. It also increases the risk of mouth soreness and causes fungal infections like candidiasis. Mouth ulcers can be painful and cause difficulty in chewing food.
Diabetes is prone to cause gum-related infections like periodontitis. It weakens the peripheral support of the tooth resulting in tooth mobility. Gum infections are a common indicator of diabetic patients.
The white tongue in diabetes is caused by a fungal infection called candidiasis. This infection usually occurs in the tongue and hard palate. It is non-scrapable and can be treated with antifungal drugs.
Diabetic patients have dry and cracked lips, which may bleed in severely damaged cases. Applying lip balms and petroleum jelly can help to keep the lips moist and prevent dryness. Also, drinking adequate water helps to hydrate the body.
Medicated mouthwashes must be used as the dentist recommends for a stipulated period. Prolonged use of mouthwash can stain the teeth. However, mouthwash is not a potent cause of diabetes. It is an additional oral hygiene measure to protect teeth and gums from microorganisms.
The tongue comprises multiple tiny taste buds that help to recognize different tastes as food is swallowed. In diabetic patients, these taste buds are damaged due to excess sugar consumption. It results in oral candidiasis, a fungal infection that can be effectively treated with medications.
Last reviewed at:
01 Aug 2023 - 4 min read
RATING
Dentistry
Comprehensive Medical Second Opinion.Submit your Case
Article Overview: Diabetes is one of the leading causes of permanent blindness. We need to be aware of how to avoid the complications of diabetes. But early detection and prevention can help prevent permanent disability. Read Article
Introduction: "Eyes are the most beautiful organs created by nature which enables us to visualize things, people, animals, etc. It is an essential factor that is necessary for individuals to be independent in their life." But a lot of health conditions not associated with the eye cause complications... Read Article
My Teeth Are Yellow.Is Scaling Only A Temporary Process To Clean The Teeth?
Query: Hello Doctor, I am 19 years old. My teeth are yellow from childhood (from 10 years of age). A black layer is formed at the backside of teeth. When I see my teeth it seems very dirty and too much of creamy layer is formed on my teeth especially in lower canines and lower incisors. In the lower teeth... Read Full »
Most Popular Articles
Do you have a question on Oral Hygiene Maintenance or Oral Prophylaxis?
Ask a Doctor Online