Dental Health	Plaque	Periodontal (Gum) Disease
Diabetes and Dental Health		Additional Resources

Diabetes and Dental Health

Know the Facts
Know Your Risk Factors
Manage Your Risk Factors
Work with Your Dentist and Your Doctor

Know the Facts

• Tooth and gum problems can happen to anyone. A sticky film full of germs (called plaque [PLAK]) builds up on your teeth. High blood glucose helps bacteria (germs) grow. Then you can get red, sore and swollen gums that bleed when you brush your teeth.
• People with diabetes can have tooth and gum problems more often if their blood glucose stays high. High blood glucose can make tooth and gum problems worse. You can even lose your teeth.
• Smoking makes it more likely for you to get a bad case of gum disease, especially if you have diabetes and are age 45 or older.
• Red, sore and bleeding gums are the first sign of gum disease. This can lead to periodontitis (PER-ee-oh-don-TY-tis). Periodontitis is an infection in the gums and the bone that holds the teeth in place. If the infection gets worse, your gums may pull away from your teeth, making your teeth look long.
• If you have one or more of these problems, you may have tooth and gum damage from diabetes:
• Red, sore, swollen gums.
• Bleeding gums.
• Gums pulling away from your teeth so your teeth look long.
• Loose or sensitive teeth.
• Bad breath.
• A bite that feels different.
• Dentures (false teeth) that do not fit well.

Know Your Risk Factors

• Poor dental hygiene.
• Poorly controlled blood sugar.
• Smoking and smokeless tobacco.
  Need another reason to quit smoking? Smoking is one of the most significant risk factors associated with the development of periodontitis. Smokers have 7 times the risk of developing gum disease compared to non-smokers. Additionally, smoking can lower the chances of success of some treatments. Tobacco use in any form - cigarette, pipes and smokeless (spit) tobacco - increases the risk for gum disease, oral and throat cancers, and oral fungal infection (candidiasis). Spit tobacco containing sugar increases the risk of tooth decay. For more information on how to stop smoking, click here. If you would like information on HIP's Quit For Life Quit Smoking Program, call 1-866-QUIT-4-LIFE (784-8454) TDD: 1-877-777-6534.

Manage Your Risk Factors

• Keep your blood glucose as close to normal as possible.
• Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times.
• Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line at a 45? angle to the teeth and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth.
• If you wear false teeth, keep them clean.
• Ask the person who cleans your teeth to show you the best way to brush and floss your teeth and gums. Ask this person about the best toothbrush and toothpaste to use.

Work with Your Dentist and Your Doctor

Visit the dentist regularly. Check-ups can detect early signs of oral health problems and can lead to treatments that will prevent further damage and in some cases reverse the problem. Professional tooth cleaning also is important for preventing oral problems, especially when self-care is difficult.

• Get your teeth and gums cleaned and checked by your dentist twice a year.
• If your dentist tells you about a problem, take care of it right away.
• Be sure your dentist knows that you have diabetes.
• Call your dentist right away if you have problems with your teeth or gums.
• Call your dentist if you have red, sore or bleeding gums; gums that are pulling away from your teeth; a sore tooth that could be infected; or soreness from your dentures. If you smoke, talk to your doctor about ways to quit smoking. For more information on how to stop smoking, click here. If you would like information on HIP's Quit For Life Quit Smoking Program, call 1-866-QUIT-4-LIFE (784-8454) TDD: 1-877-777-6534.
• Plan ahead. You may be taking a diabetes medicine that can make your blood glucose too low. This very low blood glucose is called hypoglycemia (hy-po-gly-SEE-mee-uh). If so, talk to your doctor and dentist before the visit about the best way to take care of your blood glucose during the dental work. You may need to bring some diabetes medicine and food with you to the dentist's office.
• If your mouth is sore after the dental work, you might not be able to eat or chew for several hours or days. For guidance on how to adjust your food plan and normal routine while your mouth is healing, ask your doctor:
• What foods and drinks you should have.
• How you should change your diabetes medicines.
• How often you should check your blood glucose.

At your dental visit:

• Your dentist will ask about your medical history to identify underlying conditions or risk factors (such as smoking) that may contribute to periodontal disease. Tell your dentist about your diabetes and any other medical conditions you have and about all the medications you are taking.
• Your dentist or dental hygienist will examine your gums and note any signs of inflammation.
• Your dentist or dental hygienist will use a tiny ruler called a 'probe' to check for periodontal pockets and to measure any pockets. In a healthy mouth, the depth of these pockets is usually between 1 and 3 millimeters. (There are 25 millimeters in one inch.)
• Your dentist or dental hygienist may take an x-ray to see whether there is any bone loss.
• Your dentist may refer you to a periodontist, a specialist who treats gum diseases.

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