Diabetes involving increase in blood sugar (glucose) levels gives rise to many serious health consequences. Consistently high blood glucose levels can lead to serious diseases affecting heart and blood vessels, eyes, kidneys, nerves and teeth. In addition, people with diabetes also have a higher risk of developing infections. In almost all high-income countries, diabetes is a leading cause of cardiovascular disease, blindness, kidney failure and lower limb amputation.
People with poorly controlled diabetes are at greater risk for developing dental problems.
Too much glucose in blood from diabetes can cause pain, infection and 
other problems in the mouth. The areas affected by high blood sugar in mouth includes,
• Teeth
• Gums
• Jaw
• Tissues such as tongue, roof and bottom of the mouth and inside of the cheeks
The affected individuals are more likely to have
• Infections of their gums worsening gum disease
• Problems with the bones that hold the teeth in place known as periodontal (gum) disease
• Cause dry mouth
• Lessen saliva which allow more tooth-decaying bacteria and plaque buildup
SYMPTOMS
Diabetic individuals should be careful if they,
• Have bleeding or sore gums
• Get infections often
• Have bad breath that won’t go away
• Painful chewing difficulties
• Tooth loss
• Dry feeling in the mouth, often or all the time
These symptoms can lead to more severe tooth disease that requires immediate attention by consultation with dentist.
PREVENTION STRATEGIES
• Good blood glucose control is the key to controlling and preventing mouth problems. People with poor blood glucose control get gum disease more often and more severely than people whose diabetes is well controlled. Keep the blood glucose levels to the targeted numbers.
• Beside maintaining blood glucose levels, blood pressure, and cholesterol at or close to normal can help delay or prevent diabetes complications. Therefore people with diabetes need regular monitoring of these parameters.
• Eat healthy meals and follow the meal plan that you and your doctor or dietitian have worked out.
• Daily brushing and flossing along with regular dental check-ups are the best defense against the oral complications of diabetes.
• Brush your teeth at least twice a day with fluoride toothpaste. Fluoride protects against tooth decay.
Brush your teeth first in the morning and before going to bed and, possibly, after each meal.
Try to use a soft toothbrush which will not affect your wounds over the gums.
Gently brush the teeth with toothbrush angled towards the gum line.
Brush the front, back and top of each tooth. Brush the tongue, too.
• Use dental floss to clean between the teeth at least once a day. Flossing helps to prevent the plaque from building up on the teeth.
• If you smoke, stop smoking as it can worsen diabetes and mouth problems as well.
TALKING TO YOUR DENTIST
• Tell your dentist that you have diabetes and what medicines you take.
• Let the dentist know if your blood sugar level is off-track and if you take insulin.
• Let the dentist know about your most recent dose.
• Get your teeth and gums cleaned and checked by your dentist twice a year.
• Your dentist may recommend that you do it more often, depending upon your condition.
REFERENCES
• http://www.idf.org/complications-diabetes
• http://www.webmd.com/diabetes/dental-problems
• https://www.nidcr.nih.gov/OralHealth/Topics/Diabetes/
• https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/gum-disease-dental-problems
• http://www.michaelmarcusdds.com/GumDisease/Diabetes.aspx
• http://www.webmd.com/diabetes/dental-health-dental-care-diabetes
