The Specialist

Diabetes and oral care: your guide to total wellness

In The Bahamas, the statistics on uncontrolled diabetes is staggering. This confirms a public health crisis. The prevalence of diabetes in 2005 was 6.7 percent. It has now reached almost 15 percent and, if we include pre-diabetics, we have a prevalence of almost 20 percent. Our death rate from diabetes stands at 38 deaths per 100,000 persons, according to Ministry of Health statistics.

Diabetes affects dental and overall health, so personal responsibility is critical in its management.

The prevalence of diabetes is directly related to lifestyle choices. Diabetes is now the fifth leading cause of death in The Bahamas.

Diabetics are at greater risks for poor health. It is one of the leading comorbidities that places great strain on the body’s ability to heal. The immune system is made up of white blood cells called neutrophils. The sole function is to eat up the bacteria and stop them. However, in many diabetics, the neutrophils can no longer sense the bacteria, so the disease spreads and infections get worse. This is also one reason why diabetics are more prone to medical infections. However, if the diabetes becomes controlled, the neutrophils recover and can find and kill the bacteria.

While the blood test commonly used to diagnose diabetes is called the Hemoglobin A1C, which averages your blood sugar control over 60 to 90 days, recent studies suggest that what may be more important is the control of “spikes” in your blood sugar levels.

Each spike, occurring after a high sugar or starch meal, can cause damage.

For people who feel that they can cheat and keep their blood sugar low for the next couple of days to make their A1C look better, it just doesn’t work that way. That is one reason why your medical doctor wants the blood sugar to be tested throughout the day to be sure that your diabetes is continually under control. In that way, your neutrophils are always protecting you from infection.

The good news is that if you are diagnosed as a type 2 diabetic and you are “controlled” along with good dental care, you have a good chance of keeping your teeth and reducing your chances of generalized infections.

Diabetics are more prone to dental diseases: Periodontal disease involves the loss of bone support for the teeth. Statistics by the American Academy of Periodontology place periodontal disease at 50 percent of the adult population. This makes periodontal disease one of the most prevalent diseases in The Bahamas. It is usually identified by a dentist or dental hygienist during examinations or cleanings. Where there is bone loss, it forms a “pocket”. The deeper the pocket, the more severe the disease.

Oral care is critical to overall health: The higher your blood sugar, the greater damage to teeth and gums. Additionally, more acid is produced, further eating away the enamel.

Also, infections such as periodontitis cause blood sugar levels to rise. This, in turn, makes diabetes more difficult to control. Preventing and treating periodontitis with regular dental cleanings can help improve blood sugar controls.

Make a commitment to manage your diabetes: Monitor blood sugar levels and follow the doctor’s instructions for keeping blood sugar levels within your target range. The better controlled the blood sugar levels are, the less likely one is to develop gingivitis and other dental problems.

Brush at least twice a day: Brush in the morning and especially at night just before bed time. Use a soft-bristled toothbrush and a toothpaste that contains fluoride. Avoid vigorous or harsh scrubbing which can irritate your gums and damage your teeth. Use a new toothbrush at least every three months.

Floss at least once a day: Flossing helps remove bacterial plaque between your teeth and under your gum line. If there is trouble getting dental floss through the teeth, use a waxed floss. If it’s still too difficult to manipulate the floss, then use a floss holder.

Schedule regular dental visits. Visit your dentist at least twice a year for professional cleanings, x-rays and follow-ups.

Inform your dentist of your diabetes: Every time you visit your dentist, remind them that you are a diabetic. The effective management of diabetes is a lifelong commitment that includes proper dental care. Undoubtably, personal efforts will be rewarded in the long term with a greater sense of health and vitality.


• Dr. Kendal V.O. Major is the founder and CEO of the Center for Specialized Dentistry, which is a comprehensive family dental practice operating in New Providence and Grand Bahama. He is the first Bahamian specialist in gum diseases and dental implants since 1989. He is also a certified fast braces provider. His practice is located at 89 Collins Avenue, New Providence. He can be contacted at (242) 325-5165 or kmajorcsd@gmail.com.

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