To Your Health: Good oral hygiene can help manage, prevent diabetes

By Alfred Casale - To Your Health
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My granddaughter Rowan went to the dentist last week. It went beautifully. Her mom, Kate, had prepared her so well and had talked it up so much that Ro must have thought it was a play date.

Kate, you see, has been a dental success story — never had a cavity, sees her dentist twice a year, brushes and flosses about 23 times a day — all because of Dr. Melissa, her pediatric dentist in Baltimore, who along with Mary instilled great habits early.

Oral health is a bigger deal than many of us realize. Research has shown that it is associated with cardiac health, cancer, infectious diseases and now diabetes.

Diabetes is more than just a high reading on a blood sugar test. It’s a disease that can cause complications throughout your entire body. Diabetes is fairly common, too — it’s estimated that 30 million Americans have diabetes. Depending on your individual health, diabetes can affect your mood, weight, eyesight, kidneys and heart.

If you have diabetes, you and your doctor are likely already monitoring these risk factors. But there’s another thing to keep an eye on as well — your teeth.

Believe it or not, your teeth can have an effect on the progression of diabetes. By keeping your teeth healthy, you can better manage your diabetes and help keep your blood sugar where it should be.

Blood sugar is measured by tracking your hemoglobin A1c (also called HbA1c or just A1c), which tells doctors how much sugar is dissolved in your blood on average over a several-month period. If your A1c measures higher than 6.5 percent, you probably have diabetes.

In a recent study, researchers found that people with better oral hygiene tended to have lower blood sugar readings. This supports previous research that shows that oral bacteria can contribute to Type 2 diabetes.

How diabetes contributes to gum disease

Normally, your body regulates how much sugar makes it into your bloodstream. But when you have diabetes, your body stops responding appropriately to insulin — the hormone that regulates sugar levels. This causes blood sugar levels to increase, which causes damage throughout the entire body.

Diabetics are more susceptible to gum disease — in particular periodontitis, a severe form of gum disease where pockets form between the teeth and gums. Bacteria can form in these pockets and eventually cause teeth to fall out. In some cases, your teeth may even need to be pulled.

People with diabetes need to take extra care in brushing their teeth and getting their teeth cleaned and checked regularly by a dentist.

In one study, a group of diabetics received thorough dental cleanings below the gum line while another group did not. The group that received thorough cleanings had better blood sugar levels.

Oral care can prevent more than cavities

For diabetics, a clean mouth can mean a lower A1c. Similarly, a clean mouth can help reduce your risk of getting diabetes in the first place.

Research shows that gum disease can lead to diabetes — just as diabetes can lead to gum disease. Because of this ‘two-way street,’ researchers believe there’s a very strong relationship between oral bacteria and insulin resistance.

What to do next

If you have diabetes, the first step is to talk to your dentist. They will alter your dental care to meet your needs as a diabetic. Your dentist can also recommend oral hygiene strategies. However, at the end of the day, the daily care will fall to you — so you need to commit to keeping your mouth healthy.

If you don’t have diabetes, managing your dental health can be a way to keep your risks down. Commit to a regular dental routine and regular dental visits. If you’re at risk for diabetes, ask your dentist what you can do to improve your cleaning regimen.

Congratulations to Rowan; she’ll need to work to meet her mom’s standards. Oh, and by the way, Eve, our 5-month-old angel, got her first tooth! That reminds me, I missed my last cleaning. See you soon, Dr. Grossman!

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By Alfred Casale

To Your Health

Dr. Alfred Casale, a cardiothoracic surgeon, is Associate Chief Medical Officer for Geisinger Health and Chair of the Geisinger Cardiac Institute. Readers may write to him via [email protected]

Dr. Alfred Casale, a cardiothoracic surgeon, is Associate Chief Medical Officer for Geisinger Health and Chair of the Geisinger Cardiac Institute. Readers may write to him via [email protected]