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Dentistry in diabetes
diagnosis and management
` Martin Gillis and Steven Saxon
Much attention is given to heart disease, nerve damage, Diabetes manifests itself in the mouth.
Therefore, in addition to looking after
kidney disease, and eye damage which can develop in
the oral health of people with
people with diabetes. However, the mouth (oral) health diabetes, dentists also play a role in
screening for disease in the general
complications associated with diabetes are often population.There is a strong
overlooked. The oral complications of prime concern are relationship between a person's oral
health and their general health. In
gum (periodontal) disease, dental caries, dry mouth some people, such as in those with
(xerostomia), oral soft tissue damage, and pain in the diabetes, the first signs and symptoms
of a medical condition can develop in
face and mouth (orofacial pain). the mouth.These people can be
referred to their family physician for
further diagnostic tests.
In order to diagnose the potential presence of these
conditions, it is very important for people with diabetes to Oral complications
The oral complications of diabetes,
have dental examinations at least every 6 months. In this like other complications associated
with the condition, are related to a
article, Martin Gillis and Steven Saxon look at the oral
person's ability to control blood sugar
health of people with diabetes with regard to the oral levels (glycaemic control) and their
overall health. People with well-
symptoms of undiagnosed diabetes, the oral health
managed diabetes have fewer or less
complications which can develop in diagnosed diabetes, severe complications than those with
poorer glycaemic control.
the oral health-care management of people with diabetes,
and national oral health-care policy as it relates to Periodontal disease (periodontitis)
affects the gums and bone which
diabetes. support the teeth. It is an
inflammatory disease, triggered by the
>> bacteria in dental plaque, which results
in the infection of gums followed by
the destruction of bone.The
symptoms of periodontitis are hardly
noticeable at first; but as the disease
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September 2003 Volume 48 Issue 3
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progresses, symptoms such as This is mainly due to higher sugar and nerve damage (neuropathies) may
bleeding gums, tooth sensitivity, (glucose) levels in the saliva further complicate the xerostomia.
recession of gums, bad breath surrounding the teeth.
(halitosis), swollen gums, itchy gums, Oral neuropathies can be either
and loose teeth become apparent.
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(
changes in mood, and frequent In a check-up, people with diabetes for
trips to the toilet. a person with consultations with dentists to
undiagnosed assess their oral health status with
These symptoms would alert the diabetes may respect to the oral complications
)
dentist to refer this person with of diabetes. The goals of the clinic
show oral
diabetes to their family physician were to:
symptoms which
for diagnostic blood work to test increase public awareness of the
could alert the
for diabetes. The diagnosis and oral complications of diabetes
treatment of diabetes is not within
dentist of the educate people with diabetes
the scope of practice of the condition. about the importance of good
oral health and the necessity of
regular visits to the dentist
uncover the barriers which
people with diabetes face in
seeking oral health care.
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September 2003 Volume 48 Issue 3
Health Deliver y
( )
which is integral for dealing with
2000.
The financial and oral health-care issues.Templates of
social costs of oral this kind provide a foundation for
3. US Department of Health and
disease are high. the health-care policy makers and
Human Services. National call to
educators to give health-care
action to promote oral health.
providers the resources necessary
Rockville, MD: US Department of
Action programmes need to be to improve the public's well being.
Health and Human Services, Public
developed in order to reach this
Health Service, National Institutes of
and other oral health-care goals.
Health, National Institute of Dental
A second document, 'A national call
and Craniofacial Research. NIH
to action to promote oral health',
Publication No. 03-5303, Spring 2003.
prepared by the office of the US
Surgeon General, outlines the
objectives necessary to attain these
goals.These objectives apply to oral
health and diabetes through the:
recognition of oral health care as
an accepted component of
diabetes management
accumulation of scientific
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September 2003 Volume 48 Issue 3