Living with diabetes can be tricky, especially when it can lead to painful problems for your smile. Over 1 in 10 Americans—34.2 million—have diabetes, with the numbers for diagnosed cases rising among children and teens in the past decade. What is diabetes? Diabetes is a chronic disease in which a person’s pancreas either can’t produce or efficiently use the insulin your body needs to create energy out of blood sugar (glucose). Due to this deficiency, these diabetes patients have high glucose levels that can damage their body, from the eyes and nerves to the kidneys and heart. It also puts you at risk for potentially deadly conditions like heart disease and stroke. There are two kinds of diabetes. With type 1 diabetes, the pancreas can’t create insulin at all, so daily insulin injections are needed to keep patients alive. Type 1 used to be known as juvenile diabetes due to its being almost entirely diagnosed during childhood and early adolescence. Type 2 diabetes patients can’t produce enough insulin, or their body rejects the limited amount of insulin it makes. Type 2 is the most common form of diabetes, usually developing in late adulthood with patients 45 years and older. However, it is becoming increasingly more popular with younger people as childhood obesity rises. Diabetes symptoms range from type 1 to type 2 and from patient to patient. Some people with type 2 live with diabetes for years before being diagnosed. So if you suspect you may have diabetes, please keep an eye out for these common warning signs: Increased thirstiness and hunger Frequent or heavier peeing Slower healing, particularly for sores and cuts Unexpected weight loss (Type 1) Weight gain (Type 2) Chronic exhaustion Dark discoloration of the skin, usually at the neck and armpits Dry mouth Itchy skin Blurred vision Frequent and recurring infections Pain or numbness in your legs and feet As dentists, it’s critical that our patients tell us when they have diabetes. Their condition severely affects their smile’s health, causing dry mouth, cavities, gum disease, and other oral infections. If you or a member of your family have diabetes, please let our dentists at Long Beach Family Dentist know. We want to make sure your oral health is always on track. By informing us of your condition, we’ll be able to take your diabetes into account and ensure your smile is at its best.

Dental Decay and Cavities A person might typically have anywhere between four and ten cavities in their lifetime. However, many of our patients with diabetes can develop just as many in a few short visits. What causes cavities, and what makes people with diabetes so vulnerable to them? When plaque, tartar, and bacteria build up on the surface of a tooth, they like to go to town on the tooth and begin wearing away at its hard enamel. Normally, the body has a natural defense that prevents these cavity bugs from collecting easily: saliva. However, many diabetes patients find that their mouths produce much less saliva than they used to, developing a chronic condition called dry mouth. Dry mouth makes it easier for tooth decay to get a foothold on your smile. Once bacteria and decay break through the outer enamel, a pit called a cavity is made as they continue to ravage through the softer inner layers. If left untreated, this cavity will deepen as decay makes its way down to the root and eventually kills your tooth, requiring extraction. Signs you may have developed a tooth cavity: Visible hole in your tooth White or dark spots or tooth discoloration Toothache—can be sharp and lasting or come and go Sensitivity to hot and cold Lingering sensitivity to sweets Painful chewing How Is Tooth Decay Treated? Once a cavity forms, your tooth decay is treated by removing all of the plaque, bacteria, decay, and damaged dental tissue harming your tooth and then restoring the tooth to its former glory. Typical restorations include dental fillings and crowns. When the decay reaches the tooth’s pulp, a root canal is needed to clear a tooth of all decay down to the root, which is much more intensive than other cavity treatments. The tooth will then be reinforced with a crown or filling to protect it from further bacteria and dental decay. Sometimes, however, a cavity has destroyed so much of a tooth’s structure and vital dental pulp that it can no longer be restored. Even a root canal, a dentist’s last defense against decay, isn’t enough. The tooth must instead be removed to prevent your tooth infection from spreading to the rest of your smile. Periodontal Disease When you have diabetes, your body isn’t as equipped to tackle bacteria, making your smile much more prone to developing periodontal (gum) disease. Gum disease is an insidious inflammation and infection of the gums that at first seems relatively harmless or even unnoticeable. Once it reaches its later stages, however, it can create permanent problems for your smile by uprooting your teeth from their solid place in your gums. Without professional preventive care, your teeth may even need to be extracted! Gum disease symptoms include: Red or purple gums Painful, swollen gums Bleeding gums, especially when brushing or flossing your teeth Teeth sensitivity Bad breath and taste in your mouth that don’t go away Receding gum line and teeth that look longer Periodontal abscesses Pain when eating Loose teeth and new gaps between teeth Change in bite What Happens If Periodontal Disease Goes Untreated? Without treatment, periodontal disease can ruin your smile as you know it. As plaque and bacteria attack your gums, your gums begin to pull away from your teeth and recede. Deep pockets form between your teeth and gums. These allow food particles, bacteria, and plaque to collect faster and attack your gums and the critical connective tissues holding your teeth in place. Your teeth will eventually become loose and start shifting, creating unsightly gaps between them and often making it painful to eat. For patients with dentures, your prosthetic may no longer fit as well as they did before as the gums and bone structure they rest on change. At its worst, your teeth may become so fully unrooted that they fall out! However, gum disease still won’t be done with your smile after you’ve lost a tooth. It will continue its way through your mouth, infecting nearby teeth until it has destroyed your entire smile. As this happens, oral bacteria may also enter your bloodstream, where it can attack the rest of your body. Is Periodontal Disease Reversible? Only the first stage of gum disease, gingivitis, is reversible. At this point, plaque and bacteria have only irritated but not permanently damaged your gums. With excellent and consistent dental hygiene, your gums will soon be able to breathe again and return to their usual healthy pink. Gingivitis treatment usually requires a dental cleaning and flossing once and brushing your teeth twice daily for at least two weeks. After the gingivitis stage, however, your periodontal disease can only be contained as we manage any damage to your smile. You will need a professional gum disease treatment from one of our Long Beach dentists to minimize and even stop your infection. Some periodontal procedures include: Deep cleanings Pocket reduction (gum flap surgery) Gum and soft tissue grafts Bone grafts Guided tissue regeneration Without aggressive and responsive treatment, your periodontal disease may worsen to the point where we cannot preserve your teeth at all. Eventually, we may need to extract the tooth to stop your gum disease from spreading.

Oral Thrush As the body has a hard time fighting off bacteria with diabetes, many of our patients develop oral thrush, a fungal infection of the mouth. Oral thrush usually occurs with babies and toddlers, but both high blood sugar and dry mouth allow thrush to flourish on the soft parts of the mouth for our older patients. And as a fungus, this infection can be passed to others, particularly when you kiss your partner. Thrush can lead to such painful problems as: Raised white or red lesions on your gums, inner cheeks, tongue, and lips, which can bleed if scraped Loss of taste Redness, burning, and soreness Difficulty swallowing Red or cracked skin around the corners of your mouth Bad taste in your mouth How Do I Prevent Developing Oral Thrush? While you may be more susceptible to thrush due to diabetes, there are several things you can do to stop it before it ever develops: Drink water and rinse your mouth after meals or using an inhaler Eat healthy foods low in sugar and yeast which can help strengthen your immune system See your Long Beach dentist regularly for cleanings and exams Maintain excellent oral hygiene habits by brushing your teeth twice a day with a fluoride toothpaste and flossing daily Stop smoking Manage your glucose levels at your doctor’s instruction