by Dr. John Zyzo, DMD 

Over the years, studies have shown the growing connections between oral health and overall systemic health.

Current practices call for a preventative antibiotic treatment prior to dental care, whether it involves a routine dental cleaning or a more invasive extraction. In either case, the risk is introducing bacteria from your mouth into your bloodstream and causing problems in other parts of your body, especially areas that may have undergone surgical interventions such as artificial valves or prosthetic joint replacements, like knees or hips. These practices clearly demonstrate this oral-systemic link. 

Diabetes is a common systemic condition that can also be linked to oral health.

The most common links pertain to diabetes diagnosis, periodontal health and dental caries (cavities). 

You may have heard a story about a dentist diagnosing a patient with diabetes. This can happen because diabetics can give off a sweet or fruity odor on their breath. The cause of this dangerous situation is called diabetic ketoacidosis and this patient may have unsafe levels of ketones in their bodies. If a dentist is able to notice this symptom, they can often help in the diagnosis and refer their patient for further blood testing. Other systemic diseases can first present themselves with specific oral findings so dentists can play a significant role in the health screening process. 

Another problem with diabetes and uncontrolled blood sugars is the link to periodontal disease.

People usually bend the truth about their flossing habits, but if you floss like a boss and still have red puffy gums, it could be a sign that diabetes is impacting your gum health.

Poorly controlled blood sugars and gum disease are a two-way street, meaning that they cause problems in both directions. High blood sugar disrupts gum health and poor gum health is shown to disrupt blood sugar control. Thus, making it even more important to have great blood sugar control, and still floss like a boss.

You can’t do one without the other. 

Next, dental caries, more commonly known as the dreaded “cavity”.

In my experience, patients adhering to strict low carb diets are much less susceptible to having cavities. Not to mention the benefits of greater blood sugar control and lower A1c levels.

The reason being, bacteria in our mouths love sugar and carbohydrates. When we eat these foods, the bacteria eat them as well. This allows the bacteria to create an acidic by-product that ultimately creates cavities in your teeth. The less carbs and sugars you eat, the less the bacteria have to eat. And ultimately, the less cavities you need fixed. Don’t forget, this applies to sugary fruit juices, sodas and sports drinks as well. 

There are other oral health conditions to consider when managing diabetes.

These include dry mouth and infections. Due to inflammatory processes that may disrupt salivary glands, many diabetic patients experience dry mouth. This lack of saliva makes it difficult to remove plaque and keep your teeth healthy. In addition, higher blood sugar levels can change the pH in your mouth and create an acidic environment which is also bad for your teeth. Chewing sugar free gum, sucking on sugar free mints or cough drops and sipping water can help stimulate salivary flow. There are also some mouth rinses that provide a lubricating layer which can mimic the effects of saliva (Biotene).

Delayed wound healing and recurring infections are also common amongst diabetic patients. Often times, antibiotics are required to assist in healing after surgical treatments such as extractions. However, a diabetic patient with good blood sugar control typically responds better to any dental treatment.

The ultimate goal in managing diabetes is having normal blood sugars and reducing the risk of future complications.

Reducing sugar and carbohydrate intake is a great step you can take towards that goal. And reducing your trips to the dentist should put a smile on anyone’s face. 

Dr. John Zyzo is a Doctor of Dental Medicine in the state of Connecticut, USA. He diagnosed himself with T1D in 2014 as a third-year dental student and is following Dr. Richard K. Bernstein’s recommendations for low carbohydrate management of type 1 diabetes.

Dr. John is dedicated to outreach and educating the diabetes community about the about the connections between diabetes and dental health. For questions, Dr. John can be found on Instagram.

Have a question about diabetes and dental health?

Or how to achieve more predictable blood sugar levels and help prevent dental complications?

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