Good oral hygiene is important

Diabetes can affect oral health, and conversely. It increases the risk of periodontitis and tooth decay, both of which can be complications of diabetes. Therefore, it's important to keep an eye on your mouth and teeth when you have diabetes.

To maintain good oral hygiene and prevent periodontitis, you can do the following:

• Brush your teeth with toothpaste at least twice on a daily basis. Use a small, soft toothbrush or an electric toothbrush.
• Brush your teeth in circular movements and remember to brush your tongue as well
• Use a toothpaste with flour (fluoride). Flour prevents tooth decay. The tube should preferably carry the text 1450 ppm
• Spit out after brushing but omit rinsing. This way, the flour in the toothpaste will protect your teeth for as long as possible
• Keep the gaps between your teeth clean by using toothpicks, teeth gap toothbrushes or dental floss. Preferably on a daily basis.

Ask your dental therapist or dentist if you are in doubt as to which toothbrush or toothpaste to choose.

Gingivitis and periodontitis

If gingivitis spreads from the gums to the supporting tissues of the teeth (gums and bone), it is called periodontitis. Since 2003, periodontitis has been recognized as a comorbidity of diabetes. The inflammatory condition is caused by bacteria (plaque) in the coatings on the surface of the teeth or along the gumline.

In periodontitis, the inflammation breaks down the connective tissue and bone, leading to loose teeth, and in severe cases, tooth loss can occur.

Individuals with diabetes have increased risk of gingivitis which may develop into periodontitis. The reason for this is that high blood sugar reduces healing and resistance to inflammation.

Blood sugar of 10-15 mmol/l will increase the sugar concentration of the saliva. Prolonged high blood sugar can lead to inflammation in the gums, periodontitis, and tooth decay.

Diabetes and periodontitis often hang together, resulting in a negative spiral: Infections make it difficult to regulate the blood sugar, and the more poorly regulated blood sugar, the more difficult it will be to treat gingivitis and periodontitis. It has been shown that people with diabetes receiving treatment for periodontitis will often obtain an improved blood sugar balance and will, thus, have to reduce the dosage of blood-sugar reducing medication.

Preventive measures and treatment

Your dental therapist or dentist can perform tooth cleaning, but it is important that you, yourself, keep both teeth and gaps clean. Ask your dental therapist or dentist about how you can best take preventive measures with respect to periodontitis.

Smoking and the use of snuff significantly increase the risk of developing periodontitis. It is therefore important to reduce one's use of tobacco or snuff. The very best thing will be to stop completely.

Lack of saliva may result in dental decay

The tongue uses saliva to clean the teeth of food particles. Saliva itself also has the property of 'rinsing' the mouth.

It is not uncommon for individuals with diabetes to have reduced saliva production. Less saliva need not necessarily be an inconvenience in everyday life. It does, however, increase the risk of tooth decay – even if you do not eat much sugar.

In certain cases, you notice lack of saliva by symptoms such as e.g. dryness of the mouth, and you may find it difficult to swallow your food. Please note that thirst and dryness of the mouth may also be the results of high blood sugar.

Your dental therapist or dentist may examine whether you may have reduced saliva production and suggest various solutions to remedy such trouble.

Dentures

Some will need to use dentures – either as replacement for individual teeth (dental plate) or for all teeth (a full set of dentures). If you wear dentures, it is important to keep them properly cleaned and, thus, maintain a good oral hygiene.

It is important that you sleep without dentures. Your mucous membrane/gum needs rest and oxygen in order to reduce the risk of fungal infection (denture stomatitis). It is recommended to brush the mucous membranes/gums with a soft brush, use cleaning sticks with a foam head, or a wet disposable washcloth. Brush your dentures before putting them back into your mouth.