Diabetes and other endocrine disorders
What are the oral effects of diabetes?
Diabetes is a disease that can harm the whole body. The way you control your blood sugar is directly related to your oral health. If your diabetes is under control then you should not have any problems with your oral health. On the other hand, if your diabetes is not under control then you are going to encounter some problems with your oral health. People with diabetes can get
- periodontal gum disease that gets worse at a very fast pace
- gingivitis or gum inflammation
- xerostomia or dryness of the mouth
- poor healing inside the mouth
- thrush or oral candidiasis
- burning mouth
- burning tongue
When you do not control your diabetes then your body will be weak fighting against infections. Diabetes hurts your white blood cells, your primary defence against infection. Since periodontal disease is a bacterial infection, those with uncontrolled diabetes are most likely to have it. Their gum disease may also be much worse than the normal person.
If you have severe periodontal disease then you must get treatment right away. Failed treatment of diabetes will worsen your periodontal disease. More infections in your body will cause sugar levels to increase and this will make your health even worse. Both of them will make matters worse. If your infections are treated properly then your blood sugar may go down. You will also need lesser medicine to keep your diabetes under control.
Dry mouth or xerostomia increases your risk of tooth decay and the risk of cavities. Without little saliva, there will be lesser fluids to wash away sugars and food particles that cause bacteria. The bacteria produce acids that will lead to more tooth decay in your mouth. People who do not keep their diabetes under control will have a decreased flow of saliva in their mouths. However, there is no conclusive evidence that says diabetics have more or less tooth decay than non diabetics.
If you have dry mouth then you must simply practice regular oral hygiene to prevent tooth decay. You should talk to your dentist or to your physician about getting saliva substitutes or other ways of keeping your mouth moist. Your dentist may also recommend fluid rinses or gels that will help in preventing tooth decay.
Those with serious problems with diabetes will have trouble healing after oral surgery or dental treatments. Poor blood flow to the site is one of the main reasons for this slow healing process. Moreover, you are also at risk of fungal infection called thrush or candidiasis. This condition can be treated with fungal medication. Thrush causes a burning sensation and may sometimes also be accompanied with a bad metallic taste in the mouth. Some of the other conditions that are related to diabetes cause burning sensations in the mouth. You should have an examination with your dentist or your specialist so that you can determine whether you have thrush or whether you are affected with something else.
How will your diabetes affect your treatment at the dentist's office?
It is important to keep your dentist informed about your diabetic condition. Consider your dentist as a member of your health team already. Your dentist should know as much details as possible regarding your overall health. Your dentist must also know about your medications and your respective dosages. With this information, your dentist will be able to decide on the best treatment for you.
At the very least, your dentist should have your physician's name and your physician's phone number so that if there are any concerns or questions, they can be contacted right away. Your dentist would want to know about your blood tests. Your dentist will be interested in things like your haemoglobin A1C or your fasting blood glucose. The information will help your dentist understand your diabetes and keep it under control. If your haemoglobin A1C level is less than seven percent then your diabetes is well under control. If your level goes above eight percent then you are having trouble controlling your diabetes.
If you have diabetes then you are at a higher risk for infections and slow healing of wounds. Diabetes will affect your blood count so give your latest blood test results to your dentist during every treatment. If your diabetes is well under control then you may not need any special dental care. On the other hand, if your diabetes in not under control then you may have to take antibiotics before and after the dental treatment. This will reduce your chances of a bacterial infection. If you have cardiovascular problems or if you have kidney problems then you should consider antibiotics more important.
You should take your insulin and eat normally before you visit your dentist. Your dentist will have a source of glucose just in case your blood sugar levels drop. Your dentist may have some juice around. To be sure, you should take a source of glucose with you when you go to your dentist's office. Get your hands on some glucose tablets, crackers, or cookies. Any source of Carbohydrates will work. After you get your treatment, you should resume your normal diet right away. You should ask your dentist if it is not possible to resume your normal diet.
Those with low blood sugar episodes in the past should tell their dentist how often it occurred and how serious they were. Your low blood sugar levels will occur when your insulin levels peak. If you take insulin then you must make sure that your dentist knows about it. You should also let your dentist know when you took your last meal. There are medicines that can interfere with pills that you take for diabetes and you should inform your dentist about these pills and their respective dosages.
Always keep in mind that people with diabetes will heal more slowly than the average person. People with diabetes are also more prone to infection. You must follow the instructions of your dentist as diligently as possible so that you recover as quickly as possible.
If you are going through orthodontic treatment then you should contact your orthodontist right away if there are wires or brackets cutting the inside of your mouth. These problems must be fixed before any infections or sores form. If you have mouth appliances that are made from acrylic then you are also at an increased risk of getting thrush.
How will thyroid disease affect your dental treatment?
Radioactive iodine is used to assess and to treat several types of thyroid disease. The chemical may damage the salivary glands and may even cause them to swell. This will cause changes in the production of saliva.
Hypthyroidism is an underactive thyroid gland and if children have this condition, the upper teeth and the lower teeth may meet incorrectly. Teeth come into the mouth later than the usual. People with this condition may also have a protruding tongue and thicker lips. Many children may have none of these effects though. It really depends on the severity of the disease, the age of the child, and how long treatment has been done since the onset of the disease. Adults usually have an enlarged tongue and a horse voice.
Your dentist will talk to your physician first before you get any treatment. You must make sure that your dentist knows about the details of your condition before you go through any kind of treatment.
People who do not have their hyperthyroidism under control can experience heart problems if they receive epinephrine. Epinephrine is an ingredient that is found in a lot of local anaesthetics. Moreover, people who do not have their hyperthyroidism under control may be more sensitive to the drugs used during your dental treatment. You must discuss the dosage of certain drugs like sedatives and pain relievers before you go through any treatment.
How will pituitary tumours affect your dental treatment?
People who have tumours in their pituitary gland produce too much growth hormone. It can lead to gradual changes in the face that contain cartilage. These are the nose, the ears, and the jaw. If your normal growth has stopped then your jaw may still grow. This may result in non-proportional facial features. Your tongue may get larger too. These changes may affect the way your dentures fit.
If your pituitary tumours are not diagnosed then you may end up visiting an orthodontist and getting braces that will help in tooth or jaw growth related problems. Excess growth hormones may lead to heart diseases like high blood pressure and it may also lead to diabetes.
Your dentist can help in diagnosing your pituitary problems when they notice changes in your tongue, jaw, and your face. Your dentist will suggest that you see a physician. When your physician makes a diagnosis, your dentist should be able to administer the proper dental procedures from there.
How will Paget's disease of bone affect your dental treatment?
Paget's disease of bone is characterized by the body's breaking down of bone and its accelerated build up rate which is higher than normal. Research shows that this disease could be caused by a virus. The disease can also result in broken bones or deformed bones. If the disease involves the upper or the lower jaw then major deformities in your face could happen. One of the first signs that you may notice in Paget's disease is pain or an increase in the size of your head.
Bones that are affected by Paget's disease will have more blood vessels then normal bones. This will cause excessive bleeding after a fracture of after a dental surgery. Dentists should monitor people with Paget's disease very closely so that they could spot if the jaw bones are getting affected. This is because cancerous bone changes may happen at some point in time.