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                                                        DR. DAN PETERSON

                                                                      1415 SAGE STREET ~ GERING, NEBRASKA 69341 
                                                             
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DIABETES AND ORAL PROBLEMS

Good oral hygiene, good bloods sugar levels and regular visits to your dentist can help prevent these problems

Are Other Oral Problems Linked to Diabetes?

     When diabetes is not controlled properly, high glucose levels in saliva may help bacteria thrive causing repeated acid attacks which can lead to one or more of the following conditions.

The average dentist see over 100 patients a year that have diabetes.

 Dental Cavities. Young people with IDDM have no more tooth decay than do nondiabetic children. In fact, children with IDDM who are careful about their diet and take good care of their teeth often have fewer cavities than other children because they don't eat as many foods that contain sugar.

Gum Disease. Diabetes reduces the body's resistance to infection, your gums can become one of the tissues likely to be infected when plaque and tartar are not removed daily.  It is possible to have gum disease and not even know it.  Diabetes also impairs the healing process and periodontal abscesses can develop.  This is why regular dental checkups and periodontal examinations are so important.

Thrush. Thrush is an infection caused by a fungus that grows in the mouth. People with diabetes are at risk for thrush because the fungus thrives on high glucose levels in saliva. Smoking , required to take antibiotics often and/or wearing dentures (especially when they are worn constantly) can also lead to this fungal infection. Medication is available to treat this infection. Good diabetic control, not smoking, and removing and cleaning dentures daily can help prevent thrush.

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Dry Mouth. Dry mouth is often a symptom of undetected diabetes and can cause more than just an uncomfortable feeling in your mouth. Dry mouth can cause soreness, ulcers, infections, and tooth decay.

The dryness means that you don't have enough saliva, the mouth's natural protective fluid. Saliva helps control the growth of germs that cause tooth decay and other oral infections. Saliva washes away sticky foods that help form plaque and strengthens teeth with minerals. You may be able to try a different drug or use an "artificial saliva" to keep your mouth moist.

Taste Impairment.  Taste may diminish and influence food choices in favor of sweet tasting foods with highly refined carbohydrate content that may worsen a diabetic's dental and overall health.

Blood Vessel Changes. Thickening of blood vessels is a complication of diabetes that may increase risk for gum disease. Blood vessels deliver oxygen and nourishment to body tissues, including the mouth, and carry away the tissues' waste products. Diabetes causes blood vessels to thicken, which slows the flow of nutrients and the removal of harmful wastes. This can weaken the resistance of gum and bone tissue to infection.

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Lichen Planus and Lichenoid Reactions (inflammatory Skin Disease) Lichen planus is a skin disorder that creates lesions in the mouth.  Outbreaks may be triggered by emotional stress.  In some cases small pimple like sores erupt in the mouth forming a white lacy like pattern.  A more painful type involves ulcers that erode surface tissue.  A topical anesthetic may help to reduce an relieve some of this condition.

Bacteria. Many kinds of bacteria (germs) thrive on sugars, including glucose -- the sugar linked to diabetes. When diabetes is poorly controlled, high glucose levels in mouth fluids may help germs grow and set the stage for gum disease.

Tooth Loss. Serious periodontal disease not only can cause tooth loss, but can also cause changes in the shape of bone and gum tissue. The gum becomes uneven, and dentures may not fit well. People with diabetes often have sore gums from dentures.  If chewing with dentures is painful, you might choose foods that are easier to chew but not right for your diet. Eating the wrong foods can upset blood sugar control. The best way to avoid these problems is to keep your natural teeth and gums healthy.

Infection and Delayed Wound Healing.  Infections will make it more difficult to control blood sugar levels.  To help the healing process after a dental procedure keep your blood glucose levels under control before, during and after the procedure, especially after oral surgery.

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Yet again dentists find themselves on the front lines of a larger medical front. Dentists are  well positioned to help prevent and combat the complications of diabetes. Treating gum disease in diabetic patients can help them keep their diabetes under control. Evidence of this was noted by Dr. Sebastian Ciancio in an April 2004 Dental Practice Report article, "A conversation with Dr. Sebastian Ciancio." http://www.dentalproducts.net/xml/display.asp?file=2351

"We have data that shows if patients are diabetic and we treat their periodontal disease, their diabetes improves markedly," Dr. Ciancio observed.

Plus, the American Diabetes Association Web site flatly states: "Gum disease can make diabetes harder to control." http://www.diabetes.org/type-2-diabetes/mouth-care.jsp

Dentists can be among the first to urge patients to get tested for the chronic disease. As a dentist may be the first health- care professional to suspect a patient has diabetes, dentists can order appropriate tests or refer patients to physicians to be tested.


(Information from National Oral Health Information Clearinghouse and American Dental Association)

Advise your dentist about your medical condition BEFORE dental treatment.

09/14/2007

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          If you have any questions please e-mail me at: drdpeterson@scottsbluff.net
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PLEASE NOTE: The information contained herein is intended for educational purposes only.  It is not intended and should not be construed as the delivery of dental/medical care and is not a substitute for personal hands on dental/medical attention, diagnosis or treatment.  Persons requiring diagnosis, treatment, or with specific questions are urged to contact your family dental/health care provider for appropriate care.
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