Dental Care Deserves More Than a Brush-Off

Unfortunately, dental treatment and vision care are rarely included in basic health insurance plans. I don't know how insurance companies concluded that the eyes and the teeth are not parts of the body, but they managed it somehow. If you have diabetes, however, it's especially important to realize that contrary to the rationalizations of insurance executives, both your eyes and your teeth require attention and care.

Most people with diabetes are aware of the importance of managing their diabetes to prevent vision problems. What many don't realize, however, is that diabetes affects dental health. Both the American Diabetes Association and the America Dental Association tell us that people with diabetes are at higher risk for gum disease and other dental problems than people who don't have diabetes.

Why are people with diabetes more at risk?

People with diabetes are at higher risk for gum disease and dental problems because high blood glucose can make it difficult for the body to fight infection. High blood glucose is related to inflammation and dry mouth, which lead to gum problems, and it also increases dental caries (cavities) and tooth decay.

What is periodontal disease?

Periodontal disease is the fancy name for gum disease. ("Perio" means "around," and "dontal" means "tooth.") It starts as an infection of the tissues that support your teeth, which include your gums and the bone supporting your teeth, and it can eventually affect every tooth in your mouth. Inflammation is also involved, a process that at first helps you heal but just makes things worse if it goes on long-term.

The two stages of periodontal disease: Gingivitis and periodontitis

* Gingivitis is an inflammation of the gum tissue that occurs when an accumulation of dental plaque (a film of bacteria on teeth) reaches the margins where the gum tissue and the teeth meet. With proper care, gingivitis is reversible, but without proper care, it leads to periodontitis.
* Periodontitis is the advanced form of periodontal disease. Plaque spreads to the deeper tissues, forming "pockets" where the gums are not tight around the teeth. More bacteria can harden the plaque, creating tartar that can seat in these areas and leading to bone loss. Periodontal disease is treatable, but not reversible.

How do I know if I have gum disease?

Some people have symptoms, but many people don't. If you have symptoms, you may notice that:

* Your gums bleed easily when you brush your teeth
* Your teeth are loose
* Your gums are receding, exposing more of your teeth and making them look longer
* You have a bad taste in your mouth
* You have halitosis (bad breath)

Because gum disease is often silent and symptom-free, however, it's important to visit your dental health professionals at least twice a year (more often if recommended specifically to you). They can provide the treatment you need and teach you how to care for your teeth and oral health.

How is gum disease treated?

Treatment for gum disease depends on the stage of the disease. If you have advanced gum disease, your dental care professional may recommend surgical cleaning, antibiotics, or other treatments. In any case, you will need to visit your dental care professional regularly for professional cleanings and check-ups. Along with these visits, here are some things you can do at home:

Brush your teeth for two minutes at least once a day. Use a paste accepted by the American Dental Association, one that has fluoride and an anti-gingival/antibacterial ingredient to help prevent gingivitis. Look for the ingredient "triclosan," which has antibacterial and anti-inflammatory properties.

Use interdental devices such as floss and/or proxy brushes (brushes that reach between your teeth) at least daily to clean between your teeth

Brush or scrape your tongue at least once a day

Keep your blood glucose numbers as close to normal as possible. If your blood glucose is high, find the reason and treat it

If you are taking medications that cause your mouth to be dry, drink water, suck on ice, and chew sugar-free gum sweetened with xylitol

Prevention is the goal

Now that you're aware of the diabetes and dental connection, you'll be sure to add oral and dental care to your diabetes to-do list. When it comes to diabetes complications, putting your knowledge to work leads to prevention.