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VOLUME 8 NUMBER 4 • NOVEMBER 2011
DIABETES EDUCATOR’S FOCUS
SA JOURNAL OF DIABETES & VASCULAR DISEASE
red, sore, swollen gums
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bleeding gums when brushing or flossing. This is not normal. Even if
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the gums don’t hurt, this must still be checked
pus between the teeth and gums
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gums pulling away from the teeth so that they look long; parts of the
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root may show
loose or sensitive teeth
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bad breath
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a bite that feels different
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dentures/false teeth that do not fit well, or have stopped fitting well
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teeth that hurt when eating something cold/hot/sweet or when
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chewing
dark spots or holes in the teeth.
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Considerations when visiting the dentist
A multidisciplinary health-team approach provides comprehensive care
for people with diabetes. Each member of the team contributes particu-
lar skills and experience. Collaboration and communication are essential
components of a team-care approach, facilitating co-ordination of care.
A visit to the dentist may require the involvement of the diabetes doctor;
and the diabetes doctor may require information from the dentist. There
are some useful points to consider when visiting the dentist:
Acute infections (abscesses) should be treated immediately. Post-
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pone non-emergency dental-care procedures if the blood sugar level
is not well controlled. Should orthodontic appliances cut the gums or
cheeks, immediately consult with the orthodontist.
Keep the blood sugar levels as close to normal as possible; it is best
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to eat before the dental appointment. If on insulin, a morning appoint-
ment after a normal breakfast is best.
Tell the dentist about your diabetes status at each visit and have a list
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of the names and dosages of all medications currently being taken.
The dentist needs to know if other medications will interact with any
prescriptions that may be given.
See the diabetes doctor before scheduling treatment for periodontal
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disease. If oral surgery is planned, the doctor or dentist will advise on
any pre-surgical antibiotics required, changes to meal schedules, or
changes to timing and dosage of insulin.
The post-treatment instructions of the dentist must be closely fol-
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lowed. If the mouth is sore after dental work, the patient may not be
able to eat or chew for several hours or days. Seek guidance from
the doctor on how to adjust the normal routine while the mouth is
healing (remember this may be prolonged in the diabetic patient).
Most importantly, find out what changes are required with food, drink
and diabetes medication. Also find out how often blood glucose levels
should be checked.
Glenda Hardy
Day-to-day oral care tips
Brush your teeth after every meal, using a soft-bristled tooth-
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brush. Turn the bristles against the gum line and brush gently.
Use small circular motions. Brush the front, back and top of each
tooth. Remember to brush the rough surface of the tongue to
remove germs. Replace the toothbrush when the bristles are worn
or bent, about every three to four months.
Prevent plaque build up by using dental floss at least once a day.
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Floss reaches places the toothbrush can’t. Using a sawing motion,
gently bring floss between the teeth, scraping from bottom to top
several times. Never snap the floss into the gum.
If you have dentures, remove and clean daily.
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If smoking, talk to the doctor about ways to quit.
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Have your teeth and gums cleaned and checked by a dentist twice
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a year, although the dentist may specifically recommend closer
intervals.
Make an appointment with the dentist if you have red, sore or
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bleeding gums, or gums that are pulling away from the teeth. Also
schedule appointments for a sore tooth that could be infected, or
pain from dentures.
