The Practical Aspects

Diabetes And Oral Infections

By the very nature of the disease, it is possible that people with diabetes might be prone to infections, especially those of skin and mouth. Generally it have been observed that diabetics are predisposed to infections that affect urinary and respiratory tracts, oral cavity, soft tissues and bone.

However, no strong association between diabetes and increased susceptibility to infection has yet been demonstrated. But studies have clinically established an association between poorly controlled diabetes and various infections. This increased susceptibility is probably due to many reasons than one.

Changes in salivary flow and composition in diabetes may predispose the patient to oral infection. These changes can be reversed if one can successfully improve his/her control over diabetes. The incidence of loss of periodontal attachment in patients with diabetes is no greater than in the average population if metabolic control and oral hygiene are satisfactory.

Gingivitis, however, has been shown to be more prevalent in those with diabetes despite similar levels of plaque control. Further, when metabolic control is poor the diabetic patient will experience greater loss of periodontal (of or pertaining to gum) attachment than the non-diabetic who has similar levels of plaque control. A few of the observed infections and oral complications are explained below:

Dental Cavities: It is not a compulsory phenomenon in diabetics. And there is no law, which says that, if you are a diabetic you will have dental cavities. In fact, young people with diabetes have no more tooth decay than do nondiabetic children. Youngsters with diabetes who are diet conscious and take good care of their teeth often have fewer cavities than other children.

Thrush: Oral thrush is an infection caused by a fungus that grows in the mouth. People with diabetes are at risk for thrush because the fungus thrives on high glucose levels in saliva. Added risk arises from factors like smoking and wearing dentures. Quite a few medication options are available to treat this infection. But the need for diabetic control cant is over emphasized. It is the same case with thoroughly cleaning the dentures every day.

Dry Mouth: Dry mouth is often a symptom of undetected diabetes and can cause more than just an uncomfortable feeling in your mouth. Dry mouth can cause soreness, ulcers, infections, and tooth decay.

The dryness, is an indication of the lack of sufficient saliva, the mouth's natural protective fluid. Saliva helps control the growth of germs that cause tooth decay and other oral infections. Saliva washes away sticky foods that help form plaque and strengthens teeth with minerals.

Oral Candidosis

Oral candidosis is more common in the diabetic patient, especially when control is poor, and in those wearing dentures. In addition to the above factors leading to increased susceptibility to infection, oral epithelial cells are more receptive for Candida; hence the higher carriage rates in people with diabetes.

Any patient presenting with acute oral candidosis, for which no simple cause such as antibiotic therapy can be identified, should be referred for appropriate investigation. In addition to ensuring that blood glucose is satisfactory, antifungal therapy may be required.

Oral candidiasis and other infections may be early signs of uncontrolled diabetes. Diabetes may accentuate the resorption of bone in periodontitis, but it has never been shown to cause pocket depth formation. The patient's immune system response to dental plaque plays a major role in the initiation of pathogenesis of periodontal disease.

The control and prevention of infection, especially opportunistic fungal infections, is critical in diabetic patients. Immaculate oral hygiene should be instituted early to prevent periodontal abscesses, which are especially to fungal invasion.