Page 26 - Diabetes

seen in younger patients who had it for longer times. As we offer a medical dental service. While they may not be the
see more and more patients with Type 2 at earlier ages, this best option for a dentist, they should know those in the
difference will probably diminish.” area with extra training. A local dental society is another
The earlier onset also means that dental health care good resource.
becomes important at younger ages. Parents and guardians “Make sure you tell your dental care professionals that you
should remember that even children need to be watched have diabetes,” says Wachter. “Find out if they can accom-
and treated for oral health the same as adults. modate special needs such as stopping the examination long
Robbins also suggests being seen as soon as possible enough to check blood sugars and respond as needed. And
after the initial diagnosis of diabetes to get a good baseline ask if they are taking care of other diabetic patients.”
of your dental health. Since there can be a delay between
onset of the disease and diagnosis, it is important to make Other question to ask your dentist include:
sure that PD hasn’t already established itself. • Are you able to recognize low blood sugar during the
appointment and can you treat it if it happens?
Daily Care Recommendations • What special training or education do you possess? Was
Standard daily care is basically the same as the general it a structured residency?
population. Brush your teeth after every meal. You should • Have you completed seminars or other postgraduate work
brush at a 45-degree angle against the gums and move it focusing on medical dentistry?; and
back and forth in short strokes. Make sure you clean the • Are you a member of any interest groups or professional
front, back and chewing surfaces of your teeth. Use the organizations?
brush’s tip to clean the inside of the front teeth. There is little research backing up the idea that you
Flossing is another important part of the process. You should see the dentist twice a year. This is mostly the result
should: pull off enough floss to wind it around the middle of insurance companies long ago saying they will pay for
fingers of each hand; hold the floss tightly between your two visits. How often you will need to see the dental health
thumbs and forefingers; curve it into a C shape against one professional depends on your specific situation. Some may
tooth and gently move the floss back and forth across the only need to be seen annually, while others will visit as often
tooth and then the side of the tooth in an up and down as every two or three months.
motion; and repeat until you have flossed all your teeth.
Before using any kind of mouthwash, check with your The Power of Brushing and Flossing
dentist to see what, if any, he or she recommends. Anti- Cleaning your teeth is important because PD is a bacterial
bacterial mouthwash can contain up 20% alcohol, which can infection. The bacteria in your mouth spin out sticky pro-
further dry out your mouth. If your dental care teins that cause pieces of food and debris to
professional thinks it is needed, medicated attach to your teeth. This film is plaque, and
mouthwashes such as Peridex may be pre- it is what makes your teeth feel fuzzy when
scribed. Many dentists will suggest fluoride you wake up in the morning. It remains soft
supplements to help keep the teeth stronger. for 48-72 hours and can be brushed off before
“Part of the prevention of periodontal it starts to harden.
disease is knowing how to take care of your “This hardened material is called cal-
gums and teeth,” says Cram. “We can do all culus or tartar and contains bacteria,”
of the best treatments in the world, but if you said Robbins. “I tell my patients that this
aren’t doing what you need to do every day at is like a pebble in your shoe that causes
home, this disease won’t get better.” your foot be to inflamed and raw. The
calculus becomes a site of inflammation.”
Choosing Your Dental Professional It is the combination of the immune
If you are successfully controlling your diabetes response to the bacteria in the tartar and
and have no problems with your eyes, kidneys the toxins generated as waste products by
or heart, then you can probably see any general the bacteria that destroys the hard and soft
dentist in the community. How often will be tissues around the gum and teeth.
decided based on your dental condition. Referral Even if you are the most careful and aggressive
to a periodontist will also be a joint decision. Those brusher and flosser, you will always miss a little plaque, and
who have uncontrolled diabetes, have medical problems calculus will build up. Scraping your teeth is what removes
or may be hypoglycemic unaware (a complication where a it, making the dental visit a critical part of diabetes care.
person is unaware of a deep drop in blood sugar) should “An important take away is that diabetics should realize
consider a dentist who has additional training and experi- that somehow the mouth has gotten disconnected from the
ence in treating medically complicated patients. rest of the body,” says Robbins. “It is vitally important that
Your endocrinologist is often a good source for referrals you get regular checkups and cleaning, stop smoking, and Shutterstock/rizal mansor
and likely to have other patients who need more special- have a conversation with your dental health providers about
ized dentists. Check with your local hospital to see if they risk factors and things you can do to lessen that risk.” †
24 March/April 2018