Diabetes and Oral Health
October 5, 2000

Dear Dr. Mady: I am forty years old and my teeth are in bad shape as well as my gums. I frequently get infections in my mouth and my dentist says it is related to my diabetes. Can this disease really cause problems in the mouth, and if so, why?-Saul

Dear Saul: DIABETES mellitus is a condition where the glucose or sugar in your foods is not utilized by your body. I don't know which type of diabetes you have, but there are two main types that cause the body to not use the sugar properly.

The first type is known as Type I diabetes or insulin-dependent diabetes. This is the most serious kind.

Individuals who have this type do not produce enough insulin to absorb the glucose. Insulin is a hormone that your body is supposed to produce in sufficient amounts. People with Type I diabetes usually need to give themselves daily insulin injections in order to live a normal healthy life.

The second, and less troublesome kind, is Type II diabetes. In this case the cells in the body do not interact with the insulin properly. Individuals in this situation are required to control their diet more by watching what foods that they consume.

Food and beverages that are high in sugar and fat should be avoided. These types of people tend to go "in-and-out" of this condition throughout their lives and often take oral medications to assist them.

It is true, however that no matter which type of diabetes you have, it does affect your entire body including your mouth, teeth and breath.

I am not saying that diabetics are at higher risk of getting cavities than non-diabetics, especially if the disease is monitored and controlled. But if it is not controlled and if your diet consists of larger quantities of fat, sugar and starch, then the likelihood of cavities will increase.

Also, diabetics tend to eat more often during the day and frequent doses of sugar included in these meals in various forms can contribute to the breakdown process of the dental matrix. This simply means that you should brush and floss more often to decrease the amounts of destructive bacteria in your mouth.

Many diabetics report a dry mouth. This lack of salivary flow does not help the situation due to the fact that there is not enough saliva to wash away these bacteria. If saliva is lacking, then there is a pretty good chance that sugar will remain adhered to your teeth and have a greater opportunity to cause decay.

Gingivitis and other more severe gum diseases can be more prevalent in diabetics because their bodies do not respond as quickly to fight off infections of this type. If this infection is not treated and prevented, more serious damage to bone and underlying structures can occur, and tooth loss can result at an earlier age. Because of this it is true that diabetics who keep their disease under control have healthier gums and less tooth loss.

Many diabetics suffer from severe bad breath. It is usually displayed as a strong fetid, fruity-sweet odor and nothing can really be done to totally eliminate it. This is caused by the body naturally attempting to combat the decreased glucose use. There are many things that can be done to temporarily help including flavored mouth rinses, sugarless gum and mints, and meticulous oral hygiene care at home.

The truth is that if you watch what you eat and the frequency with which you eat, and take excellent care of your teeth, including regular check-ups and cleanings, you can only help the situation.

You may even beat it!

This column is reprinted with the permission of the author and The Windsor Star. "Ask the Dentist" is written by Windsor dentist (and ECDS member), Dr. David Mady Jr.. The column appears the first Thursday of each month in the Windsor Star. Readers with questions can write to "Ask The Dentist", c/o The Windsor Star, 167 Ferry St., Windsor Ontario, N9A 4M5



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