People Who Suffer from Diabetes at Risk for Gum Disease

For the nearly 21 million Americans who live with diabetes, problems with teeth and
gums are ranked sixth in the list of complications from the disease, according to the
National Institute of Dental Research.

The link between diabetes and an increased risk of tooth and gum disease is real. But there is a reason to smile: It’s entirely preventable, says one USC expert. Julie Jenks, a faculty member at the Herman Ostrow School of Dentistry of USC, understands this link well. A clinical professor in the school’s Advanced Pediatric Dentistry Program, Jenks was diagnosed with type 1 diabetes at the age of 12. She says that the best way to control any of the complications associated with diabetes is to keep the disease in check.

“The better handle you have on your diabetes, the less long-term complications you’ll experience from the disease,” she says.

Understanding the Link

Diabetes is a disorder that affects the way the body produces or processes insulin—the hormone that converts sugar,
starches and other food into energy needed for daily life. Jenks says that too much sugar in the bloodstream contributes to
the variety of complications associated with the disease including heart and kidney disease, eye problems, poor circulation
and nerve damage.

Consistently high levels of glucose in the body can contribute to high levels of sugar in the saliva.
Diabetes can also affect saliva function, slowing production of saliva or making it thicker.

“Saliva is the way the mouth cleanses itself of bacteria,” Jenks says. “If it’s not functioning, if you are
experiencing dry mouth or thicker saliva, then bacteria will build up.”

Add this to the way diabetes impairs the body’s resistance to infection and delays healing and you have
a perfect breeding ground for cavities and gum disease like fungal infections and periodontitis.

“High blood sugar can impair blood flow to tissues throughout the body and slows down the body’s ability to fight infection
in the gums,” she says.

People with inadequate blood sugar control experience more frequent and more severe gum disease and tooth decay than
average. If left untreated, periodontal disease can increase the body’s blood sugar, making it that much more difficult to
control diabetes.

The Mouth/Body Connection

Jenks sites a recent incident when a fellow dentist diagnosed diabetes in a patient whose oral surgery was healing slower
than normal.

“He noticed that the wound wasn’t healing nearly as quickly as it should,” Jenks says. “He asked the patient if he’d ever
been tested for diabetes. When they tested his blood sugar level with a glucometer, it was higher than normal. It turns out
he had the disease.”

It’s a perfect illustration of the relationship between the mouth and the rest of the body. “The mouth can be a window to
the health of the entire body. What happens in the body affects the mouth,” she says. “This is an excellent example of that.”

Keep Smiling

Jenks offers the following recommendations for those living with diabetes:
• Brush and floss twice a day.
• Visit your dentist twice a year and be sure to tell your oral health provider that you have diabetes.
• Combat dry mouth with a saliva substitute, or consider chewing sugarless gum to help the salivary flow.

Jenks also recommends that those with diabetes pay special attention to any changes in their teeth and gums. Regular
self-inspections should check for any discolorations, including white patches, in the gums or inner cheek, which may be
evidence of thrush—a fungal infection.

If gums are sore, swollen and red, if they are pulling away from the teeth, or if the teeth are sore or sensitive, these may
be symptoms of tooth or gum disease.

“Keep your dentist in the loop,” she says, “Ignoring tooth decay or gum disease will only make the problems worse.”
Jenks offers some special advice to those living with diabetes.

“Monitor your glucose levels regularly to keep diabetes under control. That is your best line of defense,” she says.