Articles

Diabetics are encouraged to take good care of their oral hygiene as the condition can take a toll on teeth and gums.

Gum disease, in particular, often affects diabetics who may also be prone to other mouth infections. Cape-based dentist, Dr Marc Sher, answers the following questions about this issue.

1. How does Diabetes affect oral hygiene?

• Uncontrolled type 2 diabetics (non-insulin dependent) suffer from poor oral hygiene.
• This group of patient is mostly overweight, and their diet consists largely of sugars/carbohydrates, the consequence of which leads to rampant tooth decay.
• Advanced stages of gum disease, known as periodontal disease is accelerated in this type of patient.
• Dry mouth syndrome as a result of polyuria (passage of large volumes of urine) and dehydration, adds to the development of tooth decay and bad breath.
• Candidosis (oral thrush) is often seen in this group.

1. Are Diabetics prone to mouth ulcers?

• Yes, this group is classified as having an immunodeficiency, which is a predisposing factor to developing mouth ulcers.
• Due to the fact that Type 2 diabetics take an oral hypoglycaemic drug, they can develop oral lichenoid reactions as a result. Oral lichenoid reactions are not ulcers as such, but the lesions can ulcerate in severe cases.

1. How to Dentally treat and manage diabetic patients.

• It is best to time the dental treatment on diabetic patients (type 1) as to not interrupt their scheduled insulin intake. Diabetic coma can result if insulin is not administered in time.
• Diabetic patients (type 2) are at risk of developing a hypoglycaemic coma in the dental chair if a scheduled meal time is missed. It is best to treat these patients soon after they have eaten to avoid this.
• A more rigorous oral hygiene routine is required for these patients who are more prone to periodontal disease. Cleanings every 3 months is required.
• When experiencing mouth ulcers, use a product such as Andloex oral gel 

Dr Marc Sher (B.Ch.D), practices at The Dental Practice in Sea Point, Cape Town, and can be reached via email: marc@drmarcsher.co.za.