DIABETES & ORAL HEALTH

If you, or someone you know, has diabetes you may already be aware that diabetes puts you at greater risk of gum disease and oral health problems. Less well-known is that periodontitis can increase your risk of diabetes and make it harder for people with diabetes to control their blood sugar.

The dentist may not be the first medical professional you’d associate with diabetes but – because of the powerful bi-directional link between diabetes and oral health – proactive oral care is extra important. An effective oral hygiene routine can help reduce your risk of developing diabetes and help you live well if you have the condition.

Diabetes, also known as sugar or blood sugar, is a condition that affects the body’s ability to process sugar. There are two types – type 1 and the more common diabetes type 2. Cases have risen dramatically in recent years all over the world. According to experts, it is the most common cause of death in women and second for men in South Africa, where an estimated 12.9% of the adult population have diabetes. According to the International Diabetes Federation, a vast number of people with diabetes are undiagnosed.

Gum disease is even more common, affecting about 90% of people at some point in their lives. Gum disease occurs when dental plaque, a sticky bacteria-laden biofilm, builds up on the teeth and gums, causing irritation. The gums become inflamed, red and swollen. They may bleed when brushing or flossing,

Early gum disease, known as gingivitis, can be prevented with an effective daily oral hygiene routine to remove any plaque build-up. If not treated, gingivitis becomes periodontitis, where plaque below the gum line causes severe inflammation and eventually tooth loss.

There is a well-established two-way relationship between diabetes and oral health. Diabetes affects the body’s ability to process sugar; higher glucose levels in your saliva put you at higher risk of bleeding gums, cavities, gum disease and bad breath.

In addition to the sugar issue, an estimated 42% of people with diabetes experience dry mouth, medically known as xerostomia, which is another risk factor for several dental health issues.

People with diabetes can also tend to have a lower resistance to infection and heal more slowly, which can also further exacerbate gum problems.

At the same time, people with gum disease have been shown to have poorer blood sugar control and are at higher risk of various diabetes-related complications as a result. People with periodontitis, a more severe form of gum disease, are also more likely to become type 2 diabetic.

Regular visits to the dentist and effective oral care will help you live healthier with diabetes. Once you are diagnosed, schedule a dental appointment right away. Let them know about your diagnosis and continue to go for regular check-ups which enable your dental team to detect any problems early.

A professional cleaning done by the oral hygienist at least every six months is recommended. This will help keep your mouth in tip-top shape, removing plaque and tartar (hardened plaque) that can’t be removed by brushing at home.

Likewise, keep your doctor informed of your oral health status, especially if you require oral surgery. If your diabetes is not under control, periodontal surgery and implant therapy should be delayed until glycaemic control is achieved.

A meticulous daily oral care routine is the best way to prevent most oral health problems and is even more important if you have diabetes. Here’s an easy-to-follow routine to help children and adults with diabetes protect their oral health and general well-being. A healthy mouth can be as simple as 1, 2, 3.

1. Brush

• Brush correctly at least twice a day for a full two minutes each time, right up to the gum line.
• Use a soft brush that will be gentler and cleans more effectively.
• A quality electric toothbrush – like the Philips Sonicare or Sunstar GUM ActiVital – will give a ‘supreme clean’ with minimum effort.
• Use mild toothpaste or go for an ultra-natural option like Olgani Naturals.

2. Clean in-between

• Floss or clean in-between the teeth daily.
• If you find floss too challenging, try an interdental brush or Sunstar GUM Soft-Picks.
• Not sure which to use? Ask your oral hygienist, they would love to help you.

3. Rinse

• After eating and before bed rinse with an alcohol-free mouthwash like Dentyl Active, Thryve or Olgani, alcohol will further dry out the mouth.

Over 40% of people with diabetes experience dry mouth or xerostomia. A dry mouth can make it difficult to swallow and even talk. Because saliva is the body’s way of keeping the mouth clean, plaque and bacteria build up more quickly, and you are at higher risk of bleeding gums, bad breath and dental decay.

Rehydrating the mouth is the number one priority. Drinking water will give temporary relief and chewing gum can stimulate saliva flow. Some medications help produce saliva and products like Sunstar GUM Hydral have been designed specifically to moisturise and lubricate oral tissues.

Our Ivohealth dental experts recommend these oral care products for people with diabetes.

Brush

• GUM ActiVital Sonic toothbrush
• Philips Sonicare power brushes
• GUM Sensitival toothbrush
• Olgani Naturals toothpaste or toothpowder

Interdental care

• GUM Bi-Direction or GUM Trav-Lers interdental brushes with anti-bacterial coating
• GUM Soft-Picks
• GUM Expanding Floss
• Panasonic Oral Irrigator

Rinse

• Dentyl Active
• Olgani Naturals
• Thryve Mouth salts

Protection & relief

• Dry mouth or xerostomia – Sunstar GUM Hydral Gel and Spray
• Cracked lips – Letibalm Nose & Lip Paediatric Balm

For over 30 years, Sunstar GUM has supported research and education on the relationship between diabetes and oral health, inspired by the company founder, Kunio Kaneda, who lived with the condition. We thank Sunstar GUM for their valuable contribution to this important topic.

Understanding how diabetes and oral health are inter-connected will hopefully inspire you to aim for oral care excellence. Here’s to living healthier with diabetes!

For helpful diabetes advice and information on contact Diabetes South Africa.

For personal recommendations on caring for your oral health when you have diabetes speak to your dental professional.