Diabetes and dental care: Guide to a healthy mouth

DISCLOSURE: Noelle Copeland RDH is an Oral Care Specialist and Dental Consultant who provides content for Brilliant Oral Care and Baby Buddy.

Diabetes affects the body and its ability to process sugar. The food we eat is converted into glucose (sugar) and used for energy by every cell in the body. In Type I diabetes, the body doesn’t make enough insulin, a hormone that carries glucose from our blood to the cells that need it for energy. In Type II diabetes, the body stops responding to insulin. Both Type 1 and Type 2 diabetes result in high blood sugar levels, which can cause problems with the eyes, nerves, kidneys, heart, and other parts of the body, including the mouth.

Estimates show that diabetes affects over 30 million Americans and worldwide over 400 million people. Evidence throughout the world suggests that having diabetes in any capacity increases your risk of developing periodontal disease. Inflammation plays a significant connection piece between diabetes and periodontal disease. Inflammation is a known cause of insulin resistance. Therefore, chronic periodontal disease can increase insulin resistance and worsen glycemic control when left untreated because it causes significant inflammation in the mouth.

• People with diabetes are susceptible to infections, primarily when their blood sugar is uncontrolled.
• Glucose is present in the saliva.
• When glucose is high in the saliva, oral bacteria grows.
• High oral bacteria cause inflammation, decreasing the body’s ability to control blood sugar.
• Eventually, oral health declines and systemic health falters.

In essence, diabetes can cause oral disease, and oral infection can make treating diabetes more complex and challenging.

• Type 2 diabetes is largely preventable and accounts for almost 90% of cases.
• Type 1 diabetes is relatively autoimmune, cellular-mediated, with absolute insulin deficiency.

What makes Xylitol a good choice for diabetic patients?

One of the side effects often experienced by people with diabetes is xerostomia (dry mouth). This can be due to several factors, including medications, autoimmunity, smoking, aging, salivary gland dysfunction, stress, anxiety, or medical procedures like chemotherapy and radiation. In addition, with increased blood glucose levels, people living with diabetes may have more glucose in their saliva and feel thirsty often.

Our saliva is very protective and a vital necessity for oral health. Lack of saliva causes a significant increase in plaque accumulation, caries (especially root caries), oral pain and discomfort, difficulty swallowing and eating, and makes periodontal disease almost inevitable if left untreated.

Xylitol increases salivation and raises a falling oral pH to a neutral range within a few minutes of consumption. Saliva that has Xylitol in it is more alkaline than saliva stimulated by other products without Xylitol. When oral pH is above 7, calcium and phosphate salts in saliva start to move into the vulnerable parts of the enamel. This means soft, calcium-deficient enamel sites begin to harden again, remineralizing the tooth.

Xylitol also helps fight the yeast Candida albicans, reducing its ability to stick to a surface and cause infection. A chronically dry mouth can breed a rapid yeast infection quite fast, and it is more challenging to treat an oral yeast infection than it is to prevent it. Saliva also fights cavities by washing away food debris and restoring Ph balance.

Although having some plaque on the teeth is normal, when it gets excessive, our immune system starts attacking the bacteria living in the plaque by causing inflammation in the gum tissues, leading to gingivitis and periodontal disease. Therefore, from a dental point of view, the role of Xylitol as a stabilizer of salivary calcium and phosphate ions is significant for people with diabetes.

How is Xylitol beneficial in Toothpaste?

When properly used, Xylitol may help reduce the incidence of tooth decay while increasing saliva production.

• Approximately 3-5 applications a day are effective at reducing decay.
• Because the bacteria in the mouth that cause dental caries cannot metabolize Xylitol, their growth is reduced and starved to death in a xylitol-rich environment.
• Regular usage of a tooth cleaning product containing the correct/ideal amount of Xylitol, like Spry Tooth Gel, can dramatically improve oral health.

The connection between oral health and systemic health.

The connection between oral health and systemic health is intricate, affecting one another directly and indirectly. For example, bacteria in the mouth can enter the bloodstream and cause disease or complicate immunocompromised persons already dealing with a disease or medical illness.

How you brush your teeth matters, maybe even more so than how much. Brushing your teeth with the proper technique is probably the most crucial detail in an effective home care routine, but the timing of your brushing routine is the second most important!

• The toothbrush head should be tilted to a 45-degree angle to reach the sulcus (space just underneath the gum line) while using shortened back and forth or circular motions to remove plaque, ending with a sweep from the gumline to the tooth’s tip.
• Brush a minimum of twice a day, preferably in the morning before eating and in the evening before going to bed. Brushing more may be indicated by your dental professional for certain circumstances.
• You must brush for at least 2 minutes, 30 seconds in each of the four quadrants of your mouth.
• Don’t brush after a particularly acidic meal, drink, or snack; wait 30 minutes. Oral acids remove the mineral pellicle that protects tooth enamel, and it takes 30 minutes to rebuild most of it. Therefore, brushing too soon can contribute to progressive enamel wear.
• Brushing after every meal is not typically recommended, as it can also contribute to progressive enamel wear. However, using Xylitol enhanced gum, mint, or rinses is beneficial after meals or snacks, as this helps protect teeth and prevent cavities.

Electric Toothbrushes!

I think electric toothbrushes are an excellent choice for people with diabetes. Since people with diabetes struggle with dry mouth, they also struggle with higher indices of plaque accumulation, higher rates of gingivitis, and periodontal disease. So it just makes sense that their gums and teeth would benefit a lot from the lavage, vibrations, and dual cleaning provided by an electrically powered toothbrush.

Rechargeable electric toothbrushes are the best option when it comes to power and vibrations per minute. This means they remove more plaque, bacteria and provide more therapeutically to the mouth. Some of the benefits that come with purchasing a more expensive rechargeable electric toothbrush are:

• More brush strokes per minute.
• Removes more plaque when used correctly. Follow the manufacturer’s instructions for use.
• Includes timers, LED lights, and sensors. All the bells and whistles!
• Programs that auto-ship refill parts.
• Wider-based handles for those with grip or dexterity issues.
• Keeps people engaged and accountable.
• Downloadable apps track habits and routines.

Rechargeable electric toothbrush options

• Higher vibration options range from 20,000-50,000 brush strokes per minute.
• Oscillating/Pulsating electric brushes have small circular brush heads that rotate rapidly back and forth, like a windshield wiper. When using this toothbrush, the brushing technique should be applied to one tooth and then the next tooth.
• Sonic motor electric toothbrushes have rectangular brush heads and use vibration technology to loosen plaque and bacteria from the teeth. They come in various frequencies with gear adjusting modes that account for desired results or particular circumstances like; Sensitive, Whitening, Deep Clean, Clean, Gum Care.
• Rotary electric brushes. This is a circular brush head that rotates in a complete circle. The design is similar to the prophy cup polisher a dental hygienist uses to polish your teeth at the end of a professional cleaning. When using this toothbrush, the brushing technique should be applied to one tooth and then the next tooth.

An electric toothbrush with a 20K-50K frequency range is considered a high-frequency toothbrush and should be used by guiding it over the teeth. You are just driving the brush around the mouth. It’s so powerful that you don’t need any pressure or scrubbing motions to move the bristles back and forth to remove plaque; the high frequency drives the bristles for you, so all you have to do is get the brush in your mouth and aim it correctly. I think this makes it an excellent option for diabetic patients that struggle with oral care. Greater caution is required with high-frequency designs as they are easier to misuse and can cause gum tissue recession and sensitivity.

Things to consider

• Option for most people over the age of eight years.
• Greater plaque control than a manual toothbrush.
• Helpful for those with dexterity challenges, often seen in diabetic patients.
• It creates more vibrations that may be cumbersome to acclimate to at first.
• The motor is louder and could be bothersome while using.
• Caution should be considered for those with sensory disorders.

If you were looking for effective and healthy ways to establish oral care routines for yourself or a loved one, you found the right place. If you want to try the softest toothbrush for sensitive gums, look no further than Brilliant Oral Care. https://www.brilliantoralcare.com/collections/manual-toothbrushes

Be sure to check out our selection of specialty toothbrushes for those with special needs. This includes our toothbrush for sensitive gums and teeth, which we call the “special soft” brush for special circumstances.
https://www.brilliantoralcare.com/collections/manual-toothbrushes/products/brilliant-special-soft-toothbrush?variant=7463312654383
Finding the best toothbrush for sensitive gums doesn’t have to be difficult. When oral health and systemic health are balanced, so are the rest of the body. #BRUSHBRILLIANT

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