DIABETES AND ORAL HEALTH
All too often, when seeing my patients, I’m asked why I take blood pressures, examine for oral cancer or even take a health history in the first place. In other words, what connection exists between “filling a cavity” and one’s physical health that would prompt me to do all of the above in a routine dental check-up.
The connection between oral and physical health is well documented.
Heart attacks, many times, manifest themselves as jaw pain. Systemic diseases, such as herpes, often appear as oral lesions. The administration of the wrong type of anesthetic or prescribing drugs when a patient is on other drugs for other medical conditions may precipitate a medical emergency. And these are but a few.
This week I’d like to discuss diabetes mellitus (simply, diabetes), a syndrome in which carbohydrates (sugar), fat and protein are abnormally metabolized, thereby leading to absolute or relative lack of insulin and abnormally high blood sugar. According to the American Diabetes Association 23.6 million children and adults (7.8% of the total population) have diabetes, and the number is growing.
How does diabetes impact on one’s oral health? For one thing, both diabetes and periodontal (gum) disease are intimately related through a shared inflammatory response. As I mentioned above, diabetic patients have increased blood sugar which causes decreased saliva flow thereby leading to:
- Tooth erosion, i.e. loss of tooth structure near the gum line, particularly on the sides facing the cheeks or lips.
- Extensive cavities on the roots of the teeth
- Tartar buildup and consequent gum disease leading to tooth loss
Prolonged healing times which exacerbate infections both in the mouth and other places in the body.
On the other hand, gum disease exacerbates diabetes, the presence of bacteria from gum infections making glucose control more difficult to achieve. As you can see, it’s a vicious cycle, each exacerbating the other and never ending. Needless to say, with tooth loss there are quality of life issues as well.
Oral health is only one aspect of one’s general health, but an integral part. It’s more than just filling cavities.
