Can my dentist diagnose diabetes?

Regular dental check-ups are essential for maintaining oral health, a healthy smile, and potentially identifying signs of systemic diseases such as diabetes. People living with diabetes have high levels of blood sugar (glucose). High blood sugar can damage nerves, blood vessels, the heart, kidneys, eyes, and feet and weaken white blood cells.

The damage to blood vessels increases the likelihood of infections in the soft tissues and bones that support the teeth, which means people with diabetes can be at a higher risk of developing dental problems like gum disease and tooth decay. The increase in sugar levels in saliva can also lead to an increase in the formation of dental plaque. This article explores the relationship between oral health and diabetes and explains how a trip to the dentist may uncover important clues about your well-being.

Many early symptoms of diabetes may not be evident during the early stages or may even be absent, making it difficult to diagnose. Since people typically visit a doctor only when feeling unwell, someone can live with undiagnosed type 2 diabetes for up to a decade. It is estimated that around a third of people with diabetes have not yet been diagnosed. Dentists are, therefore, often the first healthcare professionals to notice symptoms and signs associated with type 2 diabetes during routine dental examinations. They can identify individuals at risk or those with undiagnosed diabetes who can receive follow-up evaluations from their general practitioner.

What are the oral health symptoms linked to diabetes?

1. Gingivitis: Gingivitis is an early stage of gum disease that presents as red, swollen, and bleeding gums. People with diabetes are more susceptible to gingivitis due to their compromised immune system and increased susceptibility to infections. Regular brushing, flossing, and professional dental cleanings can help prevent gingivitis.

2. Periodontitis: If gingivitis is left untreated, it can lead to a more severe infection called periodontitis, which destroys the soft tissues and bones that support your teeth. This can lead to tooth loss. Diabetes can exacerbate the condition as elevated blood sugar levels create a favourable environment for bacteria that cause periodontal disease to thrive in the mouth and by reducing the body's ability to fight off bacteria. Dentists may detect periodontal issues early on and recommend aggressive treatment to control the condition.

3. Dry mouth: Dry mouth, also known as xerostomia, is often the initial symptom of type 1 and type 2 diabetes. Diabetes can cause dry mouth (and increased thirst) due to high blood sugar levels, causing a reduction in saliva production. Preventing tooth decay and neutralising acids are vital functions of saliva. A chronically dry mouth can increase the risk of tooth decay, gum disease, mouth sores, and oral infections due to unmanaged diabetes or certain diabetes medications.

4. Oral infections: People with diabetes are more prone to oral infections such as thrush (a fungal infection) due to high glucose levels in their saliva, providing a conducive environment for fungus growth. Signs of thrush include painful white and sometimes red patches on your mouth, gums, tongue, cheeks, or the roof of your mouth.

5. Burning mouth syndrome: This condition is painful and complex, often described as a burning, scalding, or tingling feeling in the mouth, and may also be accompanied by a dry mouth and bitter taste. Although the exact cause of this syndrome is not fully understood, it has been linked to diabetes.

6. Slow healing of oral tissues: People with diabetes may develop poor circulation, which leads to slower blood flow, making it challenging for the body to supply nutrients to wounds. High blood sugar levels can also affect the body's healing process, making it slower than usual. This can be particularly noticeable in the mouth where sores or surgical wounds, following dental procedures, take longer to heal.
   

Look for these signs and symptoms of oral health conditions to know if you have diabetes. And if you notice any problems, see your dentist right away.

Prevention and treatment

Prevention and early intervention are crucial to managing oral health issues related to diabetes. Here are some general tips for preventing and managing these conditions: