The Specialist

Diabetes and oral care

Most diabetics know the risks associated with the disease. It’s one of the first things your medical doctor or nurse will speak to you about when the diagnosis is made.

Today, I will address how diabetes affects your dental and overall health, and your personal responsibility in the management of the disease.

Unfortunately, there are many uncontrolled diabetics in The Bahamas. Our statistics on diabetes confirm a public health crisis.

The former Minister of Health, Dr. Duane Sands, in an article in the October 25th 2020 edition of The Tribune; said the following, “The prevalence of diabetes in 2005 was 6.7 percent. It has now reached 13.9 percent and if we include pre-diabetics, we have a staggering prevalence of almost 19 percent. Our death rate from diabetes stands at 37.9 deaths per 100,000 people.”

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

Diabetics are at greater risks for poor health:

In fact, it is one of the leading comorbidities.

Our body’s immune system is made up of white blood cells called neutrophils, whose 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 the pockets get deeper. This means bone loss. This is one reason why diabetics are more prone to generalized medical infections as well. However, if the diabetes is 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.

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

So, for those who feel that you can cheat and keep your blood sugar low for the next couple of days to make your A1C look better, it just doesn’t work that way. That is one reason why your medical doctor wants you to test your blood sugar 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 as well.

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 hygienist during your dental examination or cleanings. The bone loss is identified as a “pocket” – measuring the distance between the top of the gum and the underlying attachment to the bone. The deeper the pocket, the more severe the disease.

Take control of your health because oral care is critical to your overall health:

The higher your blood sugar, the greater the damage to your teeth. Additionally, more acid is produced, further eating away your enamel.

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

Make a commitment to manage your diabetes.

Monitor your blood sugar level and follow your doctor’s instructions for keeping your blood sugar level within your target range. The better you control your blood sugar, the less likely you are to develop gingivitis and other dental problems.

Brush your teeth 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.

Consider using an electric toothbrush, especially if you have arthritis or other problems that make it difficult to brush well. Get a new toothbrush at least every three months.

Floss your teeth at least once a day:

Flossing helps remove bacterial plaque between your teeth and under your gum line. If you have trouble getting dental floss through your teeth, use a waxed floss. If it’s still too difficult to manipulate the floss, use a floss holder.

Schedule regular dental visits:

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

Make sure your dentist knows you have diabetes:

Every time you visit your dentist, remind him or her that you have diabetes. Make sure they have contact information for your medical doctor who will help you manage your diabetes.

Helping yourself to effectively manage diabetes is a life-long commitment that includes proper dental care. Undoubtably, your 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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