Approximately 34.2 million Americans, or 10.5 percent of the population, have diabetes, according to the Diabetes Research Institute Foundation. This figure includes approximately 7.3 million people who are undiagnosed.

Diabetes can affect every part of the body, even when it’s being well-managed. Untreated, diabetes can cause serious problems, including taking a toll on the teeth and oral health in general.

Even the healthiest person has more bacteria living in their mouth than there are people on the planet. If these bacteria become prolific in the gums, they can cause periodontal disease, a chronic, inflammatory disease that can destroy the gums. People with diabetes are more prone to gum disease, according to the American Dental Association (ADA). Poor management of blood sugar increases the risk for gum problems. Conversely, as with all infections, serious gum disease may make blood sugar rise. This makes diabetes harder to control since it makes the person more susceptible to infections and less able to fight the bacteria invading the gums.

It is hard to know which is the cause and which is the effect. High levels of gingival inflammation was found in subjects with type 1 diabetes despite regular dental visits and limited secondary diabetes complications, according to a study published in the journal Diabetes in July 2018. Secondary diabetic complications or microvascular complications include damage to the eyes, leading to blindness; kidneys, leading to renal failure; and nerves, leading to diabetic foot disorders, including severe infections causing amputation and impotence. A more recent study published in February in the journal Diabetes Spectrum found the rates of missing teeth, removable prostheses and periodontal inflammation was high among hospitalized patients with diabetes.

Those with diabetes can also experience inflamed gums that lead to bleeding (gingivitis). Another oral symptom that can occur in people with diabetes is dry mouth, which is caused by a lack of saliva. Saliva protects the teeth. Having less saliva poses a higher risk of developing cavities. Dry mouth can also make it difficult to taste food. Diabetes can lead to delayed wound healing throughout the body, including the mouth. And in children with diabetes, the teeth may erupt at an earlier age than is typical, according to the ADA.

Regular visits to the dentist are important for everyone and more so for people with diabetes. Research suggests treating gum disease can help improve blood sugar control in patients with diabetes, decreasing the progression of the disease, says the ADA. Good oral hygiene and regular professional deep cleanings by a dentist can help lower HbA1c levels. (This is the average level of blood sugar over the previous three months, which indicates how well diabetes is being managed.) Controlling blood sugar levels will help oral health. This means taking diabetes-related medications as directed, switching to a healthier diet and increasing exercise. Good blood sugar control helps the body fight bacteria or fungal infections in the mouth and relieves dry mouth caused by diabetes. Health care providers should be aware of the oral health risks of patients with diabetes, and dentists should be aware of how their patients are managing their diabetes.

• American Dental Association (www.ada.org) • American Diabetes Association (www.diabetes.com) • Diabetes Research Institute Foundation (www.diabetesresearch.org) • WebMD (www.webmd.com)

IMPROVING KENTUCKY AND BEYOND, ONE SMILE AT A TIME.

Read our article in this month’s issue to learn how gum disease can impact more than just your oral health.

ukhealthcare.uky.edu/dentistry