ASK DIABTES HEALTH

Does Diabetes affect oral health? What kind of precautions need to be taken before dental surgery in case the person has Diabetes?

Tooth and gum problems can happen to anyone, but people with Diabetes appear to have tooth and gum problems more often, especially if their blood sugar levels are high. High blood sugar levels can worsen tooth and gum problems. It may also result in tooth loss. Smoking makes it more likely for you to get a bad case of gum disease, especially if you have Diabetes and are 45 years or older. The first sign of gum disease are red, sore and bleeding gums. These problems can lead to periodontitis, an infection in the gums and bones that holds

the teeth in place. If the infection gets worse, gums may pull away from the teeth, making the teeth look long. In addition, uncontrolled Diabetes causes xerostomia (dry mouth), burning sensation in the mouth (secondary to nerve involvement), increased infections especially candidiasis (fungal infection) and parotid salivary gland enlargement. Consult your dentist at the earliest if you think you have problems with your teeth or gums.

Precautions to be taken before dental surgery:

Plan ahead. Good sugar control is always recommended before any surgical procedure to help with good outcome of the procedure. Uncontrolled sugar levels delay the healing process and also increase the risk of infections.

You may be recommended Diabetes medication that could lower your blood glucose also called hypoglycaemia. Consult your doctor and dentist before the visit on how to better care for your blood sugar levels during the dental work.

If your mouth is sore after the dental work, you might not be able to eat or chew for several hours or days. Ask your doctor for guidance on how to adjust your normal routine while your mouth is healing.

Check your blood sugar levels often and maintain required intake of foods and drinks as recommended by the dentist.

Dr Nikita Desai, Consultant Dentist

Can an increase in stress levels, due to a change in lifestyle or routine like a new job or new house, affect Diabetes management?

Stress can affect your Diabetes control in two basic ways. People under stress may not take good care of themselves - they may exercise less, forget or not have timely check their glucose levels or plan meals.

Stress hormones like adrenaline may also increase blood glucose levels.

The body may respond to stress through what is called the fight-or-flight response which also causes levels of many hormones to shoot up. Their net effect is to make a lot of stored energy - glucose and fat - available to cells. In people who have Diabetes, the fight-or-flight response does not work well, leading to excess glucose levels in the blood.

It's easy to find out whether mental stress affects your glucose control. Before checking your glucose levels, write down a number rating your mental stress level on a scale of 1 to 10. Then write down your glucose level next to it. You may find your glucose levels get somewhat erratic as the stress level goes up. If so, stress may be affecting your glucose control.

One cannot always foresee or anticipate a stress-inducing situation but in certain cases like when you are making a major change to your lifestyle or routine, it is advised to stay prepared for the accompanying stress of the situation.

Consult your Diabetes team and devise a strategy with their help to keep the transition smooth.

If you expect to be busy for a few days or weeks, modify your meal plan and exercise routine to fit into the busy schedule. Trying to adhere to a rigorous exercise regime for example, may not always work out. Failure to catch up on exercise may also add guilt and further stress for you. Keep a back-up strategy, like exercising thrice a week instead of every day.

Most importantly, check your blood glucose level more frequently and keep your doctor informed of the numbers. Depending on your level of control, your doctor may modify your medication or insulin dose.

Dr Vedavati Purandhare, Consultant Physician and Senior Diabetologist