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Diabetes and oral health

Diabetes and oral health: How to take care of your teeth?

Diabetes and oral health

Many diabetics are not aware of a problem: Sugar has a negative influence on teeth and gums. This is why it is very important to pay particular attention to your oral health. Even a harmless gingivitis can endanger a good blood glucose control.


Frequently Asked Questions:

-How does diabetes affect the condition of teeth and gums?

-What is gingivitis?

-Is there a link between periodontitis and diabetes?

-Periodontitis – what is it?

-How can you protect yourself?

-When should you go to the dentist?

-Why should I inform my dentist about my diabetes?

-Why can successful periodontitis treatment and a healthy mouth improve my diabetes?

-What is still to be considered?

So how does diabetes affect the condition of teeth and gums?

In the case of long-term elevated blood glucose values, the blood supply is generally reduced, also in the area of the gums, by the altered flow characteristics of the blood. This results in the supply of oxygen and nutrients.

This, in turn, leads to a weakening of the defense mechanisms against bacterial attacks. Thus, the germs can multiply rapidly and lead to periodontal diseases. Also, the saliva production is reduced in the case of high blood sugar due to the general fluid deficiency in the body. In the saliva, however, a large number of mineral salts are solved, which constantly ensure that even the smallest “decalcifications” of the tooth melt are “repaired” again. In the case of oral dryness, a defective surface of the melt may soon develop, on which the bacterial attack leads to a carious lesion (= hole in the tooth). Diabetics, therefore, have a higher caries risk. At the same time, the acids absorbed by the food intake and resulting from the digestive processes can no longer be neutralized (= buffered) at short notice. The excess acid attacks the enamel, resulting in caries.


What does gingivitis mean?

Inflammation of the gums is called gingivitis. Responsible for this are bacteria. These are also found in healthy mouths. In the case of reduced resistance, the development of which has already been described above with the diabetic, or even with insufficient oral hygiene, the bacteria proliferate so strongly that inflammation can occur in the region of the gums, it is an ideal breeding ground for rapid multiplication in the breeding cavity of the oral cavity.

The body reacts in an inflammation with increased blood flow, in order to transport the degradation products of the bacteria. In the case of poorly adjusted diabetes, however, the blood flow cannot be increased, the bacteria can proliferate relatively unhindered and attack the gums. If the gingivitis is not treated, and the inflammation on the gingival margin between the tooth and the gum, a periodontitis, sometimes referred to as periodontitis in the mouth, may arise. This is followed by a destructive (= destructive) process along the tooth, the formation of “gingival pockets” begins. A severe tendency to bleeding in contact and pass formation in the pocket are clear signs of the progress of the inflammation. In contrast to the “simple” gum inflammation, the bone is also involved, which is gradually “progressed” into the depth. This results in the so-called “bone loss”, which leads to an increasing relaxation of tooth loss.


Is there a link between periodontitis and diabetes?

As a diabetic, you are at risk for secondary diseases such as stroke, myocardial infarction, eye, kidney and nerve damage and the diabetic foot. However, diabetes also increases the risk of serious inflammation of the teeth holding apparatus (periodontal disease) by a triple. Parodontitis has in turn negative effects on your health and the blood glucose control. Many diabetics, however, do not know that they are part of the high-risk group for periodontitis.


Periodontitis – what is it?

Parodontitis is the inflammation of the tooth retaining apparatus. Parodontitis is caused by bacteria that are located in the dental plaque (biofilm, plaque). In periodontitis, the gums and the jaw bone are chronically inflamed. This tissue, which anchors the teeth in the jaw, gradually destroys. If periodontitis is not treated, however, it can not only contribute to tooth loss, but also to worsening of general health – and in diabetics, to a worsening of the blood glucose control. Periodontal disease is a very widespread infectious disease affecting slightly more than half of adults in the USA.


Why does periodontal disease have a negative effect on my diabetes?

The chronic inflammatory herd in the mouth can be shown to have a bad effect on your diabetes. They increase the insulin resistance of the tissues and thus make the blood glucose control more difficult. This will help to prevent diabetes and increase mortality.


How can you protect yourself?

  • Take your time for your daily dental care. Brush your teeth thoroughly at least twice a day, the morning after breakfast and in the evening before going to bed. Whether you use an electric or a “normal” toothbrush plays only a subordinate role. Rather, the right toothpaste technique is crucial. Ask your dentist about it!


  • For people with reduced mobility, the electric toothbrush with an oscillating brush is often a good alternative. Electric toothbrushes have also been on the market for a very short time, which operate according to the “ultrasound principle”. In this case, the cleaning movement is no longer produced by a motor but by high-frequency sound vibrations. These devices are at least equal in their cleaning effect to the other brushes.


  • Toothpaste with added fluoride “cures” the tooth floss and thus prevents tooth decay.


  • Once a week you should use a special highly dosed fluoride gel, available in pharmacies. Fluoride-containing rinsing solutions which also delay the formation of new deposits, as well as melt-hardening, have also proven to be effective for daily use. Ask your dentist or pharmacist for it!


  • Clean the interdental spaces with floss or, even more effectively, with special tooth brush brushes, which are available in various sizes and strengths also in the pharmacy or in the well-stocked drugstore market. Never use normal “toothpicks”, they have a little cleaning effect due to their shape and lead quickly to following injuries to the tooth!


  • Disinfecting mouthwash solutions can help to combat the harmful bacteria. These should only be used after consultation with your dentist, as the uncontrolled use of these solutions can damage your normal physiological (healthy) oral flora in the individual case and, above all, permanently, and cause severe discoloration of the teeth.


  • Mouth showers are, however, suitable for removing coarse particles from places which are difficult to access but have some disadvantages. Pathogenic (= pathogenic) germs can settle in the irrigation solution and in the tube, and such germs can also enter the blood stream when the gum is inflamed Pressed . The main problem, however, is that they remove only coarse particles and do not remove the soft deposits that form on the tooth surface during the day. These are deposited after a few hours so tough-sticky on the teeth, that even a strong ray does not remove them.


  • After each meal (including intermediate meal), use a dental care gum without sugar to neutralize the harmful acids.

Diabetics who are severely ill with periodontal disease have, for example, a 2.3-fold increased risk of dying of a heart attack than diabetics whose teeth holding apparatus is not or weakly inflamed. In a renal disease as a result of diabetes, the risk of dying of renal failure is even 8.5 times higher in patients with the severe periodontal disease.

Since you as a diabetic are a high-risk group for periodontal disease, you should take your oral hygiene seriously and even without complaints the semi-annual examinations at the dentist perceive. A 2 time’s daily dental care, which specifically removes the bacterial plaque, should be self-evident to you. With dental flosses and interdental brushes, you should clean the tooth spaces daily, ie the areas that you cannot reach with the toothbrush. You should also have a professional tooth cleaning (PZR) carried out at least twice a year.

Especially as a diabetic, you should use toothpaste that protects you against plaque bacteria and inflammation. In clinical trials, the active ingredient system of triclosan and copolymer has been effective in counteracting plaque, gum bleeding, tooth decay, tooth decay, tooth decay, tooth decay, tooth decay, tooth decay, tooth decay, and the development and progress of periodontal disease.

When should you go to the dentist?

If you suspect a gum disease, go to your dentist immediately. One of the first signs is gum bleeding, in addition, swelling and redness or even pain in the affected gum portion may occur. Even if you do not have any complaints, you should always check it twice a year!

Ask your dentist for a “professional cleaning”! In this case, not only the normal scalpel is removed by specially trained assistants, but also deposits in the interstices and below the gingival margin are expertly and gently removed. The final polishing of all tooth surfaces creates the prerequisite for optimal oral hygiene. This service is paid for, but allows you permanent tooth and mouth health!


Why should I inform my dentist about my diabetes?

It is important to inform the treating dentist about your type of diabetes, the duration of diabetes, your blood glucose control and the presence of follow-up and accompanying diseases as these factors can influence the probability of periodontal disease and its course and severity. Only if your dentist is informed about your diabetes, he can optimally adjust your treatment.

In addition, diabetes in poor control of blood glucose reduces the success of periodontal therapy at the dentist.


Why can successful periodontitis treatment and a healthy mouth improve my diabetes?

Scientific studies have proven that a successful treatment of periodontal disease can not only improve symptoms in the mouth but also your diabetes. The blood glucose values were significantly reduced. This reduces the likelihood of subsequent diabetes to normal risk.

With a consistently performed and regular oral care, you can do very much to protect yourself from periodontal disease!


What is still to be considered?

For the same reasons, which are increased risks of caries, and which can lead to periodontal diseases, diabetics often suffer from disturbed wound healing. It is therefore of particular importance that you inform your treating dentist of your underlying condition. In this way, your dentist, in cooperation with your surgeon, can take the necessary precautions to ensure that these disorders are avoided as far as possible from the outset. He can then, for example, use other local anesthetics which do not further reduce the blood flow to the gums. It will also take into account that you cannot stay sober for a long time in type 1 diabetes.

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