Steven V. Edelman, MD, and Cyndee R. Fena, RDH, MT
1 March 2005

The sixth major complication of diabetes is periodontal disease.

Periodontal disease, or pyorrhea, is a painless disease of the supporting tissues of the teeth, gums and bones of the mouth.

It is estimated that 80 percent of the adult population in the United States has periodontal disease.

Once you have periodontal disease, it is almost impossible to eradicate it completely.

However, with the help of your dentist and hygienist, you can slow down its progression with early detection and aggressive treatment.

Aside from periodontal disease, the mouth is vulnerable to these other problems that can affect people with diabetes:

• Altered taste often affects people with diabetes; it may result from a change in salivary chemistry, dry mouth or the presence of yeast.
• Dryness of the mouth may result from inactive or defective salivary glands. Dryness is also a manifestation of poorly controlled diabetes.
• Yeast (candida) in the mouth is a fungal infection associated with elevated glucose levels and is a frequent complication of diabetes.
• Oral neuropathy, or numbness of the mouth, is a rare complication characterized by a burning sensation in the mouth or on the tongue.
• Halitosis, or bad breath, often occurs when periodontal disease is present. Bad breath is worsened by dry mouth. Strong breath mints may help, but they only mask the problem, not solve it.

Ask Yourself About These Warning Signs of Periodontal Disease

• Do your gums bleed easily when brushing or flossing?
• Do you have loose teeth?
• Are your gums red, swollen or tender?
• Do you have unusually bad breath?
• Do you have tartar formation (creamy brown, hard masses on tooth surfaces)?
• Have you noticed a change in the way your teeth fit together when you bite?
• Do you feel pain when you chew?
• Are your teeth sensitive to temperature?

Guidelines for Basic Oral Hygiene

1. Brush your teeth at least twice a day
2. Floss your teeth at least once a day
3. Avoid harsh mouthwashes
4. Have your teeth cleaned regularly

Precautions for Visiting the Dental Office

• Be sure your dentist knows you have diabetes and what medications you take.
• Make your appointment at an appropriate time to avoid hypoglycemia (for those on insulin therapy).
• Bring your glucose meter to your appointment.
• Try to have your blood glucose levels in goal range during dental office visits.
• Avoid long appointments; ask if a lengthy procedure can be split into separate visits.