Diabetes: Know the main oral problems that the disease can cause
If not well controlled, diabetes can affect health in a number of ways: kidney function, eye function, increased risk of infection, and mouth. In the latter case? the mouth?, special attention is needed to maintain the integrity of the teeth and gums and the general well-being of the person living with the disease. "
" Oral changes in the patient with diabetes have their incidence or progression favored by the which causes glucose to become high in the blood, "says the journalist Keller De Martini (CRO-SP 49.039), of the dentistry department of Hospital São Paulo (Unifesp University Hospital). "They are common even in patients with good or regular oral health conditions and can reach up to 80% of them."
Endocrinologist Janaína Koenen (CRM-MG 39.049) adds that saliva being affected by diabetes can bring some harm from oral health. "Susceptibility to oral infections is favored by decreased salivary flow and changes caused by diabetes in the composition of saliva itself, which loses antimicrobial proteins capable of controlling infections," he explains. "Therefore, in addition to the discomfort, the decrease of the salivary flow is a risk factor for caries and fungal lesions in the mouth. Saliva is important because it hinders the development of caries and moistens the alveolar ridge, on which the prostheses are supported. " attention is the high propensity to the development of periodontal diseases? gingivitis and periodontitis. According to Sobrape (Brazilian Society of Periodontology), people with diabetes have a 2.5-fold higher risk of presenting them than patients without the disease. ¹
The following are the main oral problems that diabetes can cause, as explained by Janaína and Keller.
The favorable environment for the establishment of bacterial colonies caused by excess glucose in the blood, and reduced resistance to infections make patients with diabetes at high risk of developing gingivitis and periodontitis.
The gums begin to swell and bleed easily, retract and show more teeth. If it is not done, the infection progresses and reabsorbs the bone around the tooth.
It may be necessary to treat with antibiotics, correct brushing, use of mouthwashes indicated by the dentist and, in more advanced cases, surgery. Breath
Bad breath of the person with diabetes may be from the stomach. It occurs because, as an alternative to burning the glucose in energy production, the body burns fat, resulting in a ketone breath, with an odor similar to that of a past apple.
Glycemic control eliminates this problem. Meanwhile, using mouthwash may be helpful.
Dry mouth (or xerostomia)
In phases of metabolic uncontrollability, patients with diabetes suffer from dry mouth, caused by decreased production of saliva from the nervous system autonomous This hyposalivation can cause cracks in the tongue, caries and wounds in the oral cavity, as well as making it difficult to fix dentures and dental implants.
Treatment can be done from several approaches. The first is the stimulation of chewing by introducing more consistent and fiber-rich foods, which can naturally increase the production of saliva. In this more natural line, one can try the gustatory stimulation, with the consumption of sour foods, and the own ingestion of more water throughout the day.For a pharmacological bias, the dentist or endocrinologist may prescribe artificial saliva or medicines that stimulate the production of saliva. There is also the possibility of doing electrical stimulation in the office, but some patients can not undergo this procedure (those who have pacemakers or who have epilepsy, for example). Acupuncture is another treatment that has good results in the stimulation of saliva production.
Vascular changes, neutrophil dysfunction (the defense cell against infection), changes in the microbiota (presence of bacteria ) and the damage to collagen synthesis (more collagen is destroyed than formed) are characteristics of diabetes that lead to late scarring also in the mouth. Injuries take longer to be eliminated and dental and gingival treatments have a prolonged recovery period.
The best way to get around the problem is to do the glycemic control of the disease.
Blister Syndrome (SAB)
This condition is characterized by burning sensation in the buccal mucosa without apparent lesions. It is also known as pinching, itching, and swelling, especially in the tongue.
The dentist or endocrinologist may indicate medications to increase the patient's well-being, but elimination of the problem also depends on the glycemic control of diabetes. > Taste disorder (dysgeusia)
There is a change in taste: either the person no longer feels the taste of food or their perception of taste changes.
Dysgeusia is usually associated with other oral problems caused by diabetes, such as the xerostomia. Therefore, its treatment depends on the solution of such parallel conditions. Regardless of the case, it is necessary to not smoke for results to be satisfactory.
Caused by the fungus Candida, this disease affects more than two thirds of patients with diabetes. High blood glucose levels, reduced salivary flow and low immunity favor the fungus adhesion in the buccal tissues. Its manifestation is through white plaques mainly on the tongue. When they are removed with spatulas, a reddish and more sensitive mucosa is revealed in the area.
Treatment is mainly with glycemic control, but oral antifungal agents help to alleviate malaise initially.
1 - http : //sobrape.org.br/wp/doencas-periodontais/diabetes-and-index-periodontal/
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