Oral health and diabetes

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You can't be totally healthy without good oral health.

November is National Diabetes Month a good time to think about diabetes and health in general. Those who do not have diabetes can think of ways to prevent getting it (eat well and increase physical activity). People with diabetes and those who are at risk for the disease also need to consider their oral health.

Research has shown that oral health and general health are directly related. Diabetes and general health are also directly related, so it makes sense that diabetes and oral health are related as well.

In a nutshell, high blood glucose levels lead to gum disease and other dental problems; periodontal (gum) disease can also lead to high blood glucose levels.

According to the Surgeon General, oral health is essential to the general health and well-being of all Americans. Because of the added health risk that goes with elevated blood glucose levels, people with diabetes have a greater chance of poor outcomes from oral disease.

In people with diabetes, high blood glucose levels lead to increased tooth loss. A national study showed that 59 percent of adults with diabetes lost teeth due to dental decay or gum disease. Gum disease occurs more frequently and with more severity in people who have diabetes.

Periodontal disease causes inflammation, and inflammation, in turn, leads to increased insulin resistance. Insulin resistance, the hallmark of type 2 diabetes, leads to elevated blood glucose levels.

Hemoglobin A1C is a measure of the average blood glucose level over the past three months. Researchers have found that eliminating periodontal infection and reducing inflammation in patients with diabetes resulted in a significant lowering of A1C.

Signs and symptoms of periodontal disease include pain; red or bleeding gums; tooth sensitivity; swollen/tender gums; receding gums; persistent bad breath; pus between the teeth and gums; changes in the way teeth fit together when biting down; sores in the mouth.

Following are some suggestions for what people with diabetes can do to improve and/or maintain their oral health:

n establish and maintain a good brushing, flossing, and rinsing routine

n visit a dentist for an oral health assessment every 6-12 months

n see a health care provider for a diabetes-focused visit every 3 to 6 months

n check blood glucose levels routinely

n check blood glucose levels more frequently if there is a mouth infection

n notify a dentist if symptoms of periodontal disease occur.

Jane K. Dickinson, RN, PhD, CDE, is the Diabetes Education Program Director at Yampa Valley Medical Center.

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