Brushing Up on Diabetes and Gum Disease

Brushing Up on Diabetes and Gum Disease
Marilyn Porter, RD, CDE

The Mouth is Connected to the Heart and Brain, and Kidneys, and…..
As with so many other conditions, people with diabetes are at greater risk for developing periodontal disease than the general population. Not only is the increased risk two-fold, but a recent study suggests that advanced gum disease may actually hasten death in people with diabetes. When periodontal bacteria enters the bloodstream it can provide the catalyst for new infections as it travels to major organs. Heart disease, stroke or kidney failure may result, each having been well documented as complications related to diabetes. In addition, the gum disease can make diabetes management more difficult. Conversely, hyperglycemia damages small blood vessels in the gums. This in turn reduces blood flow and prolongs healing. Inadequate functioning of white blood cells can also deter healing adding to the susceptibility of infections. A common infection plagued by people with diabetes is thrush. A yeast infection, this malady is associated with increased sugar in the saliva. Yet another potential cause of gum disease is dry mouth (xerostomia) or lack of saliva. These problems may contribute to increased infections and cavities and usually are easily treated.

Prevention is the Best Treatment.
Education transformed into action is key to prevention. Whether knowledge or skills are demonstrated as part of a formal teaching process or as a captured teaching moment, opportunities to convey information and techniques that may become part of daily self-care are imperative to attain and maintain oral and diabetic health.

Self-Management Plan for Plaque Attack
Along with other self-management activities, routine gum and tooth care is integral to diabetes care. Persons with diabetes should inform their dentist of their diabetes condition. Brushing between meals will remove food particles and improve blood circulation in the gums. Contrary to popular belief, a soft bristled brush is better than harder less flexible bristles. Recommended brushing time is two minutes, about four times longer than the average. The brush should be angled to reach the surface of all teeth and tongue, with careful attention given to the area between the gums and teeth. This is critical to remove plaque and is achieved by flossing.

Taking the Bite out of Gum Disease: Know the Warning Signs
Bleeding gums when brushing or flossing
Red, swollen, or tender gums
Gums that have pulled away from the teeth
Pus between teeth and gums
Foul breath
Shifting teeth
Loose permanent teeth
Changes in bite
Pain (or absence of pain)

Recipe for Making Model Teeth
Demonstrating proper brushing and flossing techniques can facilitate practical application. This easy to make model requires only four common ingredients/objects and is guaranteed to produce smiles:

Styrofoam cup, larger 12-16 oz sizes work best
Utility knife
Pink marker
Nail clipper

Procedure:
Using the knife, make several cuts from the top edge of the cup, perpendicular to the rim, being careful not to cut beyond the cup lip. These will form the “teeth”.

With the nail clipper, clip the outside corner edges of the “teeth” to give them a more rounded natural looking tooth shape.

Draw a pink curved line connecting the knife cuts along the portion of the rim opposite the clipped edges of the “teeth” to simulate the gum line above the teeth.

The cup may also be used to hold toothbrush, and floss for demonstration purposes.

References:
American Academy of Periodontology
American Diabetes Association
MEDLINEplus Health Information

Marilyn Porter, RD, CDE, received her dietitian’s degree from Western Michigan University, and will be getting her MS in Human Services from Capella University this summer. She is a recognized national speaker, and presented at the American Association of Diabetes Educators Annual Conference, 2001.

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