Diabetes is a serious disease that causes altered levels of
sugar in the blood.
Insulin is a hormone that is needed to
convert sugar, starches and other food (blood sugars) into
energy for the body.
Diabetes can either be due to a
deficiency in insulin production or the body’s inability to
use insulin correctly.
Some diabetics control their disease
with insulin, most control it through diet and exercise.
is important for diabetics to regularly monitor their
disease and to keep it under control. Uncontrolled diabetes
can lead to infections and severe complications in general.
In the U.S. approximately 18 million (approx 7%) Americans
have diabetes out of which 5 million are un-diagnosed.
Periodontal disease is the sixth leading complication of
diabetes and therefore it is of great importance.
Periodontal disease: Diabetes reduces the body’s
resistance to infection in the mouth and causes gum
bleeding, swollen gums, tenderness, pus, gums receding, gum
abscesses (pus, swelling), bad breath, bad taste, loose or
separating teeth. Tooth loss makes it difficult to chew and
digest food and therefore impacts the ability to maintain
proper nutrition and control of blood sugar levels.
a two-way street.
On the one side …. Diabetes increases the risk for
developing medical conditions, including periodontal disease
(bacterial infection). Diabetics are 3-4 times more likely
to develop gum disease than non-diabetics (20 times more
likely if they smoke). Periodontal diseases can be more
severe in uncontrolled diabetics.
On the other side … Untreated periodontal diseases can make
it harder for uncontrolled diabetics to keep their diabetes
under control. Periodontal infection disrupts glycemic
control and can raise the blood sugar. So for Type II
diabetics, not only are they at risk for gum disease, gum
disease also aggravates their diabetes. Periodontal
treatment often results in a reduced need for insulin.
Salivary gland dysfunction (Xerostomia, Dry Mouth):
Saliva helps you wash away and neutralize the food, drink
and bacteria on your teeth and soft tissues. A dry mouth can
cause inflamed, painful soft tissues, tooth decay and
Tooth decay: Teeth are covered with a sticky film of
bacteria. When you eat or drink the bacteria use the sugar
and release acids that attack the tooth and cause cavity.
Uncontrolled diabetes can cause high glucose levels in
saliva that may help bacteria cause repeated acid attacks.
Oral Fungal Infections (Oral candidiasis, Thrush):
Bacteria, viruses and fungi are natural habitants of the
mouth. Diabetics (high blood glucose levels and increased
salivary glucose), smokers, denture wearers and dry mouth
(lower salivary flow) have a higher risk of oral fungal
infection. Thrush shows as white (sometimes red) patches
that may be sore or with ulcers, located on soft tissues and
tongue and causing a painful, burning sensation. This
condition is treated by antifungal medication and good oral
Lichen Planus, Lichenoid Reaction (Inflammatory Skin
Disease): The cause is unknown. Outbreaks are triggered
by stress. It can vary from painless with a white lacy
network to painful with ulcers. There is no permanent cure,
but topical anesthetic or other medication may reduce and
relieve the condition.
Infection and Delayed wound Healing: these are high
risks for diabetics. If you are having oral surgery Dr.
Hoffmeyer may prescribe antibiotics to minimize the risk of
infection. Help yourself by keeping your blood glucose
levels under control before, during and after surgery.
Taste Impairment: The taste for sweets may be
diminished slightly. This may cause diabetics to eat more
sweet food and therefore worsen general and dental health.
Dental Visit: You may need to schedule your dental
appointment early in the morning, after you have eaten a
normal breakfast, in order to stabilize and prevent a severe
or sudden drop in your blood sugar levels. Be sure to let
Dr. Hoffmeyer know of all your medications.
Oral Surgery: Diabetics can get infections with
delayed healing. Talk to your physician in good time before
the planned surgery. Ask if you need to adjust you meal
schedule and the timing or dosage of insulin. Be sure your
diabetes is under control by taking a test of your blood
sugar. Dr. Hoffmeyer may prescribe antibiotics prior to
surgery to minimize your risk of infection. Make sure you
have received the prescription and bought the antibiotics
prior to surgery.
Your first consult with Dr. Hoffmeyer - Please have
your answers ready:
you or has anyone in your family ever had diabetes
you urinate more than six times a day?
you thirsty much of the time?
you feel numbness or tingling in nay part of your body?
your mouth frequently become dry?
you lost or gained more than 10 pounds / 5 kilos in the
you often fatigued?
Did you ever develop gestational diabetes while you were
were you diagnosed with diabetes?
type of diabetes?
medications do you take? Write them down with name and
what you take them for.
over-the-counter products do you take?.
you take insulin?
you have a special diet?
is your baseline sugar level? How you measure it? How
often do you measure it?
was your most recent HbA1c test taken and what was the
is the name, address, telephone of you diabetes care
Keep in mind that diabetes that is controlled by a diet low
in refined sugars and careful optimal oral hygiene will
reduce your risk of both periodontal disease and cavities.
Periodontal disease can be monitored and controlled just
like your diabetes. You should never let it be an
uncontrolled factor that influences your diabetes.