Teeth talk
Brush up on your tooth care routine and protect yourself from diabetesrelated complications
Okay, be honest – when was the last time you flossed your teeth or visited your dentist? Though we all know dental hygiene is important, many of us neglect our pearly whites. This is particularly problematic if you have diabetes because the condition bumps up the risk of developing health problems with your teeth, mouth and gums.
“To protect yourself, it’s important to recognise and quickly treat signs of dental changes or problems,” says Professor David Manton, from the Faculty of Medicine, Dentistry and Health Sciences at the University of Melbourne. “Good blood glucose control combined with an appropriate diet and effective oral hygiene can effectively reduce dental complications from diabetes.”
According to Diabetes Australia, tooth decay, gum disease, dry mouth, thrush and mouth ulcers are all more common in people who have diabetes. To reduce the risk, here’s what you need to know:
1
Avoid decay
Changes in glucose caused by diabetes impact the health of saliva, causing higher levels of mouth bacteria. This causes a build-up of dental plaque, which can damage tooth enamel.
“The bacteria uses sugars to create acid which can dissolve the tooth structure and cause decay,” Prof. Manton explains.
SIGNS Toothache or sensitivity with hot or cold foods. White, brown or black spots on teeth.
TREATMENT Fillings are used to treat dental cavities. If the cavity has spread into the tooth pulp, root canal may be needed.
PREVENTION
Use a fluoride toothpaste. The Australian Dental Association (ADA) recommends brushing in circles for two minutes morning and night, and flossing daily.
Cut back on alcohol and quit smoking as both damage enamel.
Reduce foods that are starchy, sugary or that stick to teeth (such as caramels) or are acidic (like vinegar or citric fruits).
Minimise snacking. “The more often snacking occurs, the higher the decay risk,” says Prof. Manton.
See your dentist regularly – the ADA recommends checks every six months for scaling, cleaning and assessment.
2
Keep your gums healthy
The risk of gum disease is three times higher in people with diabetes, shows research from the University of Texas. “If your diabetes is not well controlled, you’re more susceptible,” says
Clinical Associate Professor Matthew Hopcraft, of the Royal Dental Hospital of Melbourne. The same bacteria that cause gum disease have also been shown to contribute to heart disease, shows University of Florida research. The good news? “Gum disease can be reversed, but only with good oral hygiene,” says Assoc. Prof. Hopcraft. If it is treated, the risk of heart attack is lowered, according to a study by Boston University.
SIGNS Red, inflamed gums, bleeding when brushing or eating hard food, bad taste in the mouth.
TREATMENT Scaling and cleaning, antibiotics or minor surgical cleaning may all be used.
PREVENTION
● See your dentist if you notice sore gums or blood on your toothbrush as this may indicate gingivitis – inflammation that can lead to gum disease.
Have regular dental check-ups
● for early detection of gum issues.
Brush your tongue as well as
● your teeth to combat bacteria. Melbourne University is also developing a gum disease vaccine. It works by triggering an immune response, which produces antibodies that neutralise the destructive toxins in the bacteria that cause gum disease.
3
Moisten your mouth
Menopause, ageing and elevated blood glucose levels (BGLs) can all contribute to dry mouth. “As saliva has protective functions, dry mouth can increase risk of cavities,” adds Prof. Manton.
SIGNS Lack of saliva, a ‘stickypaste’ feeling, food sticking to teeth and soft tissues, difficulty swallowing, unpleasant taste.
TREATMENT “Includes high fluoride toothpastes and use of protective or moistening agents such as a mousse at night,” says Prof. Manton. You can ask your dentist to recommend dry mouth products suitable for you. Also drink plenty of water to stay hydrated and use sugar-free chewing gum to increase saliva.
PREVENTION
Reduce alcohol and caffeine, which can be dehydrating.
Avoid mouth-breathing, which dries up saliva.
Ask your GP about changing or reducing medications that cause mouth dryness, including codeine-based painkillers, antihistamines, antidepressants and diuretics.
4
Tame thrush
This can be increased by issues such as high BGLs, dry mouth or eating too many carbs.
SIGNS “Thrush often appears as a white patch that can be rubbed off to uncover a red patch, often on the tongue and cheeks, and is associated with an uncomfortable or burning feeling,” says Prof. Manton. “Sometimes redness and soreness also occur at the corners of the mouth.”
TREATMENT Topical anti-fungal agents, applied once or twice a day. Anti-fungal medications may also be prescribed.
PREVENTION
Good oral hygiene and denture
● cleanliness if you wear them.
Keep your BGLs within
● a healthy range.
5
Manage mouth ulcers
These are small lesions that develop on the soft tissue of the mouth in areas like the tongue and cheeks. May be triggered by harsh teeth-brushing, food sensitivities, hormonal changes and bad bacteria and usually take 10-14 days to heal. If a painful lump or pimple-like swelling develops, see your dentist immediately – this may indicate a gum abscess, which needs to be drained and treated with antibiotics.
SIGNS Red round or oval lesions which often have a white or yellow centre.
TREATMENT This includes salt water or over-the-counter mouth rinses and topical pastes, creams and gels that protect the ulcer to promote healing.
PREVENTION
Wear mouth guards when playing sport to avoid injuries.
Practise good dental hygiene (brush with medium pressure, not too heavily).
If you have a sensitive mouth, avoid foods that may cause burning such as hot chilli or strong caffeinated drinks. Other triggers in sensitive people may include soy sauce, tomatoes, strawberries or oranges. n