CERTAIN health conditions are unpredictable, you can never tell if and when they will affect you.
Diabetes mellitus is one of them and can afflict people of any age group, including newborns, depending on the type.
Approximately 600 000 to 800 000 adults in Zimbabwe alone suffer from this illness, and it is predicted that one million people may have diabetes by 2030.
If not controlled, this disease could lead to more systemic complications, namely retinopathy (could cause blindness), nephropathy (affects the kidney), significant vascular damage leading to heart attacks and permanent nerve damage, etc.
In the same vein, did you know that diabetes contributes to several oral health issues?
It is important to note that hyperglycemia (uncontrolled high glucose level in the blood) can lead to oral health issues.
Let us unravel how hyperglycemia leads to these dental issues.
Periodontal disease
The association between diabetes and periodontitis is bidirectional, meaning that diabetes may worsen periodontitis (chronic gum disease) and periodontitis may decrease glucose control.
As a result, hyperglycemia raises the risk and severity of periodontitis.
How might chronic gum disease be caused by diabetes?
According to earlier studies, the risk of developing periodontal disease was two to three times higher for those with diabetes than for those without the disease.
Since saliva’s contents are filtered straight from blood plasma, increased blood sugar or glucose also results in an increase in salivary glucose levels.
This, in turn, gives the harmful bacteria (Porphyromonas gingivalis, Tannerella forsythia) substrate fuel to produce plaque, which causes acute gum inflammation.
If left unchecked, this can worsen and eventually result in bone loss and tooth movement.
Likewise, individuals with diabetes typically have weakened immune systems, making it difficult to combat gum infection.
Hyperglycemia can also result in impaired blood circulation in the gums, which can slow the healing process by reducing the amount of oxygen and nutrients available.
Consequently, gum tissues are more prone to infection.
Conversely, chronic, persistent gum inflammation, especially periodontitis, causes insulin resistance, which compromises glycemic management.
Diabetes-gum disease's association with cognitive impairment
A consequence of diabetes mellitus, Alzheimer’s disease has been dubbed “type 3 DM” in part because of glucose hypometabolism, which results in cognitive deterioration.
Recent studies established that Porphyromonas gingivalis (Pg), a major periodontitis-associated bacterium, plays a part in Alzheimer’s disease.
Gingipain inhibitors have shown promise in treating Pg brain colonisation and neurodegeneration in experiments.
Caries (tooth decay)
More than 2,4 billion people worldwide suffer from untreated caries, or dental decay, in their permanent teeth.
Research data shows that adolescents with diabetes have two and three times as many filled teeth and untreated caries, respectively.
Haemodialysis patients with diabetes have higher rates of caries, periapical infections and tooth abscesses.
Along with a high salivary glucose level, diabetes can cause xerostomia or dry mouth, which encourages the growth of bacteria that produce acid and increases tooth decay.
Peri-implantitis (inflammation of the area around an installed implant)
Even though dental implants can be connected to the bone naturally after implantation, albeit delayed, in patients with poorly controlled glucose levels hyperglycemia is a risk factor for peri-implantitis.
Oral thrush (Candidiasis)
Since diabetes mellitus favours acid-producing bacteria and yeast which in turn encourage the development of caries and candidiasis, it is an independent predictor of oral thrush, particularly in hyposalivation (reduction in saliva production).
Candida albicans, a yeast in the oral microbial community, can attach itself to the soft tissues of the mouth either directly or because of dirty dentures, thus causing oral thrush, adding to the cumulative load of inflammation.
It has been demonstrated that dental care lowers the overall expenditure on medical care for diabetics.
Maintaining your oral health may lower chances of developing diabetes and vice-versa.
The most crucial step in achieving good oral health is treating the underlying cause, hyperglycemia, by seeing an endocrinologist or general practitioner.
As directed by your physician, adhere to your diabetes treatment plan, which includes food, exercise and medication.
Patients with diabetes must enhance their oral hygiene practices.
They must avoid sugary foods at all costs, use mouthwash free of alcohol (which kills bacteria without drying the mouth), floss and use a tongue scraper.
In terms of dental appointments, diabetic individuals must go every three to six months for extensive cleaning in order to prevent gum disease.
Drink plenty of water, chew sugar-free gum or use saliva substitutes (Biotène) if you have dry mouth.
Adequate blood sugar management combined with diligent dental care results in a healthy mouth.
- Patience Matambo is a final year BSc Dental Surgery student at the People’s Friendship University of Russia. She can be reached at [email protected]
