There are many health problems that may result from diabetes, which can lower the body's resistance to infection and can slow the healing process. This is a major concern - especially when you are trying to keep your gums and teeth healthy.

If you have been diagnosed with diabetes - it is essential that you inform your dentist and or hygienist as they will want to update their medical records.

The most common dental problems associated with diabetes are:

• tooth decay
• periodontal (gum) disease
• salivary gland dysfunction
• fungal infections
• lichen planus and lichenoid reactions (inflammatory skin disease)
• infection and delayed healing
• taste impairment
• Diabetes Webring
• Tooth Decay

When diabetes is not controlled properly, high glucose levels in the saliva may help bacteria thrive causing repeated acid attacks on the tooth enamel. This will lead to a rapid breakdown of the tooth enamel which will eventually result in a higher than normal carries rate - more cavities! It is essential that a proper oral hygiene regime be initiated and in addition, more frequent dental hygiene visits at to your dental office will minimize potential dental problems at a very early stage.

Periodontal Disease

Initiating periodontal care for the diabetic patient should be a foremost concern of physicians as it may make their task easier and reduce insulin need. Not only does the diabetic state influence the progress of periodontal disease, but active periodontal disease also influences the diabetic state. Because diabetes reduces the body's resistance to infection, the gums are among the tissues likely to be come infected. If you notice any of the following warning signs of periodontal disease please see your dentist immediately:

• gums that bleed easily
• red, swollen or tender gums
• gums that have pulled away from the teeth
• pus or exudate between the teeth and the gums when the gums are pressed
• persistent bad breath or bad taste
• 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 your partial dentures

It is possible to have periodontal disease and have some or none of the above warning signs. Those that have diabetes having an impaired metabolism may make gum tissue more susceptible to some types of bacteria. Periodontal diseases appear to be more frequent and more severe among diabetics and in  addition, because the disease itself may compromise or impair the healing process, periodontal abscesses can develop. Again - the diabetic patient needs comprehensive attention especially by the entire dental team.

Salivary Gland Dysfunction

Xerostoma, or dry mouth, is a very common complaint among diabetic dental patients. When you mouth produces saliva, it helps wash away food that collects around your teeth and gums. Without saliva, bacterial growth thrives. The constant dryness irritates the soft tissues in the mouth, often making them inflamed and painful. All of this leads to more tooth decay and accelerates periodontal disease.

With regard to treatment...   Sugarless gum, sugarless mints, frequent sips of water, melting ice chips all may help alleviate dry mouth. Your dentist may recommend a saliva substitute as well.   Restricting intake of coffee with caffeine and alcohol can also help.  If you think you are experiencing any of the above symptoms, it is essential that you consult with your dentist!

Fungal Infections (Oral Candidiasis)

Bacteria and viruses and fungi occur naturally in the mouth and the body's natural defenses and daily oral hygiene usually keep everything status quo. However, under some situations, they may proliferate and undermine or defeat the body's defenses.

Oral candidiasis, a fungal infection in the mouth appears more frequent among persons with diabetes including denture wearers. If you smoke, have high blood glucose levels or need to take antibiotics often you are more likely to have a problem with oral fungal infections.

Diminished salivary flow and in increase in salivary glucose create and attractive environment for fungal infections such as thrush which produces white (or sometimes red) patches in the mouth that may be sore or may become ulcers. It may attack the tongue causing a painful, burning sensation. It can also cause difficulty in swallowing and distort your ability to taste foods.

Any or all of the above require a visit to your dentist who may prescribe an antifungal  medication to help treat this condition.

Lichen Planus and Lichenoid Reactions (Inflammatory Skin Disease)

Lichen planus is a skin disorder that creates lesions in the mouth. Although the cause is unknown, outbreaks may be triggered by emotional stress. In one form the disease, which is generally painless, small pimple-like sores erupt in the mouth forming a white lacy network that somewhat resembles lichen on a rock. A more painful type of lichen planus involves painful ulcers that erode surface tissue. Although there is no permanent cure, again, this should be brought to the attention of your dentist!

Infection and Delayed Wound Healing

Infection is a major risk for the diabetic patient and can make it more difficult to control blood glucose levels. To help the healing process, keep your blood glucose levels under control before, during and after any dental surgery.  An antibiotic may be prescribed by your dentist to minimize the risk of infection.

Taste Impairment

With diabetes a diminished ability to taste sweets may be evident, yet may not be severe. Altered taste sensations, barely susceptible to most diabetic patients, may influence their food choices in favor of sweet tasting foods with highly refined carbohydrate content. This may worsen the diabetic patient's dental health and overall health.

In Conclusion...

Regular dental checkups and periodontal screenings are important for all patients but are even more important for the diabetic patient. It is most probable that your dentist and dental hygienist will recommend more frequent visits to monitor your dental health. Your home care should be at the highest level always - especially if you are a diabetic. Dental procedures that create the potential for delayed healing may require modifying your diet and your medication regimen - your dentist may advise you to change your meal schedule or dosage of insulin and this will vary based upon the dentist and the procedure.  It is especially important to inform your dentist that you have diabetes as several drugs used for dental treatment can have an effect on controlling glucose. Prior to any dental treatment please inform your dentist of all of the medications you are taking including any over-the-counter medications as well.

Be on the lookout for signs and symptoms of oral disease and Contact your dentist immediately when a problem becomes apparent. Practice good oral hygiene at home, follow your physician's dietary and medication instructions and schedule regular dental checkups to maintain a healthy smile!