This blog post is written in the spirit of “the more information, the better.” I have nothing to gain by scaring young or newly diagnosed people with diabetes. Sharing my knowledge and experience is, however, a great gain to me - one of the few things I can offer the diabetes community. That said, you don’t need another source of anxiety or resentment: diabetes is riddled with them. If I wasn’t so vain this may not be an issue at all, come to think of it. Anyway…
Let me start by saying, I have bad teeth. I’ll refrain from speaking of people with diabetes as a whole having poor dental health and just stick to what I know: I know the bad teeth of which I speak of are in my head. (Some are no longer in my head, true, but we’ll take that into account when it comes up.) I’m going to briefly run through issues that can be identified as contributing factors of poor dental health in people with diabetes.
- Hypoglycemia at nighttime. When you’re a child – or have a child – with diabetes who wakes up hours after bedtime in a panic of sweat and tremors, instinctively we reach for sugar. My go-to was hard candy and a roll of those things was never more than a few feet away. I would mash my teeth together, breaking the candy pieces into shards with jaws like an ice-breaking ship, impacting my teeth with a sugar coating that I could still taste in the morning. At another point in my diabetes history I would keep one of the beloved plastic honey bottles on my nightstand, intentionally within arm’s reach. More than once I’ve woken up with sweet, crystallized drool hardened to my face. Believe me, brushing my teeth after a nighttime low blood sugar was never a priority during childhood and, quite frankly, isn’t even now. When you feel that your very grip on existence and hope of survival are shaky, dental hygiene takes a rear seat.
- Medication. Medication affects one’s teeth in more than one way. Probably more than two ways actually, but these are the two I know have impacted my chompers: (1) it can cause discoloration and (2) it often causes mouth dryness that promotes decay. Neither of these side effects are limited to people with diabetes but, as a population, we really take a lot of meds. More than one dentist has recommended I chew gum, which is why I have jaw muscles like a pit bull (and quite excellent breath).
- High blood sugars. High sugars lead to dry mouth and, as I stated above, dry mouth can have its own headaches. First of all, high blood sugars make mouths dry by simple dehydration of the body. But worse, saliva in our mouths has glucose in it! People with diabetes without good control are like plaque farmers: plaque is basically an undesirable germ that causes cavities and tooth decay.
- Circulation. Yeah, you’ve heard this before: people with diabetes may have poor blood circulation. You heard me right: it’s not limited to your fingers and toes. Nerve damage (diabetic neuropathy) associated with diabetes can also weaken the function of the salivary glands, causing a decrease in the production of saliva. Yes, here we are at “dry mouth syndrome” again.
- Self-care may become jeopardized. Now I reeeeeally am just speaking for myself (I’m hoping this topic will ring familiar with one or two of you). Depression can be common in individuals with chronic diseases. Depression is the WORST complication, because it can affect every area of your diabetes self-management. Self-care means you have to care for yourself (see how I did that?) and, when you’re battling depression (or completely flattened by it), sometimes brushing your teeth is too much to ask. Again speaking for myself, I’ve been there.
- Finances. I know, I know! I’m a broken record when it comes to complaining about the expense of diabetes (and wanting the same things other people want – like, specifically, designer handbags). Here’s my beef: when you have conditions in your mouth that are known to be a result of diabetes AND these conditions bring on serious oral problems, why is it so hard to find a dentist who specializes in this? I can’t tell you the number of times I’ve suggested my hygienist go back to school for a year, educate herself/himself on diabetes and oral health, and open their own specialty clinic. Seriously, the amount of money people with diabetes spend on eye care is but a fraction of the expense of dental work and yet we hear so much more about our vision.
Anyhoo, that’s what inspired this week’s cartoon. Who wouldn’t laugh at the Tooth Fairy being hit up for more money because the diabetic owes so much to the dentist?! (I might need to explain that breaking someone’s knees is a stereotypical punishment – and threat of worse to come – that mafia hit men used to use when people were slow paying their debts.) That’s what we call ironic humor.
NOTE: Information posted on Podder Talk is not intended to be taken as medical advice. Always consult with your healthcare provider for questions and guidance on managing any health-related issues.