Diabetic? Visit Your Dentist!

By Anna Giacalone, D.M.D.

Diabetes is a chronic disease which affects your body’s ability to process sugar resulting in high blood sugar. High blood sugar can cause problems with many parts of the body, can lower your resistance to infection and can slow the healing process.

Diabetics are at greater risk for developing oral health problems. The most common oral health problems associated with diabetes are:

Gum disease

Diabetics are at greater risk for developing both types of gum disease: gingivitis (early form of the disease where no bone is lost) and periodontal disease (bone loss present). Both gingivitis and periodontal disease are inflammatory diseases. Disease begins when bacteria in the plaque (sticky colorless film that continuously forms on teeth) causes the gums to become inflamed. Toxins produced by bacteria in the plaque irritate the gums. The toxins stimulate a chronic inflammatory response.  The body mounts a defense to rid itself of the disease producing bacteria and their toxic by-products, and in doing so, destroys itself. The bone that supports the teeth is destroyed and plaque is able to migrate further down the root surface harboring more dangerous bacteria. The more the disease progresses, the more aggressive the response. A vicious cycle can take place unless treatment is rendered. Without intervention teeth may be lost.

Since diabetes impairs one’s ability to fight infections and to heal, fighting gum disease is more difficult. In fact, a dentist is often the first healthcare professional to suspect that a patient has diabetes when there is an unexplained increase in gum inflammation or a less than satisfactory response to treatment for the disease.

Not only does diabetes put an individual at higher risk for gum disease, but conversely, gum disease makes diabetes harder to control.  Blood sugar increases with infection. In my career, I have had more than a few diabetic patients who were sent to our practice  to have all sources of dental infection diagnosed and treated for the purpose of getting blood sugar under control. After dental treatment, the blood sugar indeed was easier to manage.

Fungal infections 

Since diabetes compromises the immune system, a diabetic is prone to developing fungal infections. The most common fungal infection is candida or thrush. It often appears as a white film on the tongue, palate, cheeks or throat. Symptoms include painful sores and difficulty swallowing.

Infection and delayed healing

When a diabetic patient requires oral surgery, the dental surgeon usually consults with the patient’s primary medical doctor or endocrinologist to access the patient’s status. A well-controlled diabetic without other serious medical compromises can often have dental procedures including dental implants with the same success as healthy patients. Many times antibiotics are used before and after surgery to assist the patient compromised by diabetes in controlling infection. Blood sugar is monitored as well as other vital signs at the time of surgery.  Sometimes the medical team must work together to improve the blood sugar before surgery can be performed.  In severe cases, non-elective dental surgery must be done in a hospital setting to better manage the medical complexities that may arise.

Poor Nutrition

Tooth replacement which will allow for proper chewing and digestion of healthy whole foods is important for all, but even more so for the diabetic.Tooth replacement with implants, implant retained dentures, well-designed, well-fitted removable partial and full dentures is essential to proper nutrition.

Diabetics should make their dentist part of their medical team to help control blood sugar and maximize quality of life.

Anna C. Giacalone, DMD, MAGD

Master of the Academy of General Dentistry

Education:

• BS. Biology Chestnut Hill College

• DMD. University of Pennsylvania School of Dental Medicine

• Certificate and Internship: Comprehensive Orthodontic Institute

• Certificate: prestigious Dawson Academy of Advanced Study

Awards:

• Pennsylvania Dental Association Award for Excellence during the four years of dental school

• Top Cosmetic Dentist Main Line 2007, 2011-2014 (chosen by peers)

• Top Dentist in Delaware Valley, 2008; Delaware Valley Consumer Checkbook    (chosen by patients)

• America’s Top Dentists 2010 – 2014 Consumer Research Counsel

• Mastership in the Academy of General Dentistry 2013

To learn more visit her web site: www.giacalonedmd.com