Gum disease, in particular, often affects diabetics who may also be prone to other mouth infections. Cape-based dentist, Dr Marc Sher, answers the following questions about this issue.
1. How does diabetes affect oral hygiene?
– Uncontrolled type 2 diabetics (non-insulin dependent) suffer from poor oral hygiene.
– This group of patients are mostly overweight, and their diet consists largely of sugars/carbohydrates, the consequence of which leads to rampant tooth decay.
– Advanced stages of gum disease, known as periodontal disease is accelerated in this type of patient.
– Dry mouth syndrome as a result of polyuria (passage of large volumes of urine) and dehydration, adds to the development of tooth decay and bad breath.
– Candidiasis (oral thrush) is often seen in this group.
2. Are diabetics prone to mouth ulcers?
– Yes, this group is classified as having an immunodeficiency, which is a predisposing factor to developing mouth ulcers.
– Due to the fact that type 2 diabetics take an oral hypoglycaemic drug, they can develop oral lichenoid reactions as a result. Oral lichenoid reactions are not ulcers as such, but the lesions can ulcerate in severe cases.
3. How to dentally treat and manage diabetic patients.
– It is best to time the dental treatment on diabetic patients (type 1) as to not interrupt their scheduled insulin intake. Diabetic coma can result if insulin is not administered in time.
– Diabetic patients (type 2) are at risk of developing a hypoglycaemic coma in the dental chair if a scheduled meal time is missed. It is best to treat these patients soon after they have eaten to avoid this.
– A more rigorous oral hygiene routine is required for patients who are more prone to periodontal disease. Cleaning every 3 months is required.