FYI

November is American Diabetes Month. It’s a great time to raise awareness of the disease with your patients and staff, including the role of regular exams in early diagnosis and the importance of oral health care in managing diabetes.
 

The link between diabetes and oral health

For your patients with Type I and Type II diabetes, receiving appropriate, ongoing dental care is vital. Diabetes has a strong connection to poor oral health and has been linked to a number of oral health conditions, including:
 

• Increased sugar levels in saliva and decreased saliva production (xerostomia), which can lead to tooth decay
• A reduced ability to fight oral infections
• A higher chance of developing periodontal disease, which can lead to tooth loss
• Cervical class V lesions associated with caries or recurrent caries
   

And while there’s quite a bit of evidence that diabetes can negatively affect oral health, there’s also some evidence that poor oral health can worsen diabetes.

More than 37 million people in the U.S. have diabetes, according to the Centers for Disease Control and Prevention (CDC). To put that in perspective, that’s nearly 15% the country’s population. As many as one in three American adults has prediabetes. The CDC also estimates that more than 20% of the people who have the disease are unaware they have it.

Along with taking a toll on your patients, diabetes also takes a toll on the economy: Medical costs and lost work and wages for people with diabetes add up to more than $300 billion per year.
 

Steps you can take for your patients with diabetes

To help you care for your patients with diabetes effectively, here’s a helpful guide created by Dr. Michael M. Tarighati, DMD, MAGD, MPH, a dental consultant for Delta Dental.
 

Educate your patients

Work together as a team to manage their oral health. This includes discussing the role of nutrition as it relates to diabetes and its potential oral manifestations. Offer these patients a nutritional questionnaire with examples of healthier food options that promote healthy outcomes.
 

Schedule appropriate times for treatment

To avoid hypoglycemic episodes, schedule your patients with diabetes in the morning, after they’ve had their breakfast and taken their oral medication, such as metformin, or injected with insulin. Make sure you give these patients breaks between treatments and don’t book lengthy appointments of over one hour. Remember that these patients need regular snack and restroom breaks.

For more complex procedures, such as root canal or crown and bridge procedures, consider scheduling multiple appointments and breaking up the length of the appointment into multiple shorter ones.
 

Ensure these patients are on regular recall visits every six months

Regular exams are important to let you thoroughly examine the patient’s mouth and, with the aid of recent radiographs, to rule out presence of caries. You can also detect potential signs of oral cancer and look out for suspicious lesions, sore spots and root caries.
 

For patients with periodontal disease, schedule periodontal maintenance visits every three to four months

Assess their periodontal status via full-mouth periodontal charting. Treat via scaling and root planing.
 

Instruct the patient on how to maintain an effective dental hygiene regimen

Show your patients how to brush with a soft bristle toothbrush and fluoride toothpaste twice a day, especially after meals, and floss every night. Consider recommending an electric toothbrush with soft bristles, such as those from Sonicare, and an essential hydrofloss aid, such as a Waterpik.
 

If needed, prescribe an extra-strength toothpaste

Prescribe 5,000 PPM fluoride toothpaste for caries prevention or remineralization. It’s also important to assess salivary flow and prescribe xerostomia relief mouth spray, gel or oral rinse.
 

Offer teledentistry options for patients with mobility concerns

These services are crucial to ensure these patients have access to the care they need. Delta Dental makes remote consultations available through Delta Dental – Virtual Consult.
 

Consider the patient’s overall health

Confirm that these patients are well supported and collaborate with their physicians when necessary. This includes making sure they have access to a glucometer and other essential tools. 

Finally, don’t forget to tell your patients about Delta Dental’s online resources such as Grin! magazine and our wellness library. These resources are full of informative content, including articles about the links between diabetes and oral health and tips for maintaining oral health, overall wellness and more.