Diabetes and Oral Health

There are over 200,000 people living with diabetes in Ireland, it is not an easy condition to live with, but plenty can be done to support self-management and better blood glucose control to live a long and healthy life. Looking after your oral health is important at any time but did you know that it is especially important to do so if you are a person with Diabetes?

There is a significant body of evidence that shows that keeping blood glucose levels stable and looking after your oral health may help prevent gum disease, which is the most common dental disease affecting those with poorly managed diabetes.

There are two types of gum disease, gingivitis causes redness and swelling of the gums. If this is neglected it may advance to the more serious periodontal disease - a chronic inflammatory disease that can destroy the gum tissue and the bone supporting the teeth, leading to wobbly teeth and tooth loss. This inflammation makes it more difficult to control diabetes as it may raise blood glucose levels. Additionally, people with diabetes are at a higher risk of gum disease because of poor blood glucose control.

Practicing good oral hygiene and regular professional cleaning can also help to control blood glucose levels.

A healthy mouth is an important part of good overall health and incorporating the following into your daily routine is a good start.

Toothbrushing One of the first symptoms of gum disease that you may experience is bleeding gums. Healthy gums don't bleed after brushing your teeth. If your gums bleed, don’t stop brushing your teeth, as it could be a sign of early gum disease, but make sure to let your dentist know. Use a soft-headed toothbrush and brush your teeth gently twice daily at bedtime and one other time for 2-3 minutes using fluoride toothpaste (1450 ppm) which helps to protect your tooth enamel. Spit out toothpaste, don’t rinse after brushing, as this will wash the fluoride off your teeth. Replace the brush every 3-4 months as worn bristles are not effective at removing the plaque from your teeth. Also remember to floss daily or use interdental brushes to reduce plaque build-up between your teeth and under your gumline. Make sure to ask your dental team for advice on the correct technique so that you don’t damage your gums.

Diet Having a healthy diet is an important part of good oral health and in managing your blood glucose levels, so make healthy food choices and eat lots of fruit and vegetables which are both tooth friendly and diabetes friendly. Follow the advice of your doctor/dietitian/diabetes team.

Hydration and Dry Mouth Some people with diabetes also experience a lack of saliva, a condition known as dry mouth, which can be caused by high blood glucose or some medication.  Without saliva to keep your mouth moist and help protect your teeth, you could be at risk of tooth decay, gum disease and thrush.

Stay well hydrated with water, sipping it or using saliva substitutes can help relieve dry mouth. Chewing sugar-free gum can increase saliva production. Avoid sucking sweets or drinking sweet drinks as these can cause tooth decay (unless treating an episode of Hypoglycaemia <4.0mmol/L).

Thrush and Diabetes People with diabetes may be more likely to develop oral infections such as oral thrush, which is a fungal infection caused by the yeast Candida albicans. Signs of thrush include painful white or red patches inside your mouth. Risk factors for Thrush are high blood pressure, and high glucose levels, ill-fitting dentures, and frequent antibiotic usage. Practicing good oral hygiene can help you avoid oral thrush and talk to your dentist or doctor for advice.

Smoking increases your risk of serious diabetes complications, including gum disease and loss of your teeth. It also increases your risk of mouth cancer, bad breath, stained teeth, and cardiovascular disease. If you smoke, ask your dentist or doctor for advice to help you quit.

Visit your dentist it is important if you are a person with diabetes to visit your dental team for regular check-ups and cleanings, every 6-12 months, they can give you a deep cleaning if required. Always advise your dentist that you have diabetes.

To help you along the way the Dental Health Foundation has developed a ‘Diabetes and Oral Health’ postcard for adults You can download it HERE for free or order it from our website.

Paediatric Diabetes

According to Diabetes Ireland, Ireland has a high incidence rate of type 1 diabetes in children and adolescents with on average 285 new cases of type 1 diabetes in those under 15 years diagnosed annually. The International Diabetes Federation Diabetes Atlas (2021)Ireland is in the top 25% for diabetes incidence worldwide but this number appears to be stabilising.

Two very useful resources regarding Paediatric Diabetes are:

HSE Paediatric Diabetes Resource Pack

Meeting the Care Needs of Primary School Children with Type 1 Diabetes during School Hours

Additionally, Diabetes Ireland has lots of support for people living with both type 1 and type 2 diabetes and their families. See www.diabetes.ie  or call them on 01 8428118.