Diabetes risks to your patients

Approaching 4 million people in the UK are known to have diabetes, with a million more cases suspected. As a dental professional you are well positioned to help spot early indications of the disease and give your patients valuable advice.

The hallmarks of uncontrolled diabetes include (but are not limited to): dry mouth and burning sensation, brittle teeth, dental caries, oral thrush, an acetone smell, ulcers, increased susceptibility to infections

and delayed healing. Some diabetics will not exhibit any of these symptoms, of course, but they must still be made aware of the importance of an immaculate oral hygiene routine to prevent any problems. Data confirms that diabetes is a major risk factor for periodontitis. In fact, susceptibility to periodontitis is increased approximately threefold in people with diabetes. Consequently, there may be erosion of the periodontium and bone resorption, which can result in teeth moving and becoming misaligned, potentially increasing the likelihood that these patients will seek orthodontic surgery.

Patients suspected to have the condition should get checked by their GP and make appropriate changes to their diet, with exercise also being recommended where possible. Provided that patients with diabetes keep control of their glycaemic states and are properly monitored, it is not a contraindication for treatment. Periodontitis is often present in diabetic patients and should be treated prior to any orthodontic procedures.

Recent developments

A ‘sugar tax’ was recently implemented whereby a levy has been added to particularly sugary drinks. The intention was to encourage companies to reduce the sugar content of their products, and to sway consumers into buying beverages with either less sugar, or sugar-free alternatives. We should, perhaps, sound a note of caution over pushing people towards sugar substitutes. Artificial sweeteners have been linked to a number of health conditions including Type 2 diabetes, with some suggesting that these products could be just as bad, or worse, for the consumer than ordinary sugar. This is a controversial area, with much debate and conflicting study results being produced, however, it may be wise to inform patients of the potential risk so they do not develop a false sense of security regarding these products. On the bright side, a reduction in consumption of sugar-rich beverages should at least help reduce levels of tooth decay.