By Consultant Diabetologist Dr.S.Nallaperumal
High blood sugar impairs a wide range of functions in white blood cells especially neutrophils and monocytes. These activities are particularly important in limiting the invasion and to fight and kill the pyogenic and other bacteria. The dental problems common in diabetics are caries tooth, periodontitis, gingivitis, pyorrhea and slow healing of the gums after tooth extraction, thus emphasising the need for proper dental care.
Also, tissue fluids in persons with diabetes also contain a high amount of glucose. This high ambient glucose is conducive to the growth of certain microbes, in particular, the fungi belonging to the Mucor and Candida families and certain bacteria. High concentration of glucose causes glycation of some enzymes and proteins involved in the host’s response to inflammation. This leads to not only a less than adequate host response, but also affects the healing process.
The blood sugar must be within reasonable limits before undertaking any dental procedure. In the presence of infection, the physician may have to use insulin temporarily to control the blood sugar. Temporary use of insulin in this situation also improves the healing rate. If the patient is on aspirin, it should be stopped atleast 3 days prior to the procedure to avoid excessive bleeding.
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Dental care & prevention of oral diseases:
Gum disease represents a risk to oral and general health, and is a major cause of premature tooth loss. Gum disease has been linked to diabetes, heart disease and arterial problems. With good oral hygiene gum disease can be prevented. The symptoms of gum disease include darkened or swollen gums, a bad taste or smell in the mouth, or bleeding. If any of these occur an immediate consultation with your dentist is advised. Oral health is just a part of general health and you cannot call yourself healthy without good oral health as well.
Follow these instructions for maintaining good dental care:
- Brush your teeth thoroughly twice a day, preferably after breakfast and before retiring to bed, with a fluoride toothpaste.
- Use a small-headed soft to a medium toothbrush with round-ended bristles and change it when it becomes out of shape. Consult your dentist or hygienist on how to brush.
- Eat sensibly. Avoid sugary food and drinks in between meals.
- See a dentist at least once a year to check all is well.
- If you floss, it is important to do it properly so that you clean around your teeth without damaging your gums.
- Bad breath can be caused by poor oral hygiene or gum disease – see your dentist.
- Smoking leads to earlier tooth loss and, with excessive alcohol use, can lead to oral cancer.
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