Most of us don’t give our teeth a second thought unless we get toothache, but good dental health (the practice of keeping the mouth, gums and teeth clean to prevent dental problems) is important, especially for people with diabetes.
Although anyone can get gum disease, it is estimated that people with diabetes can be up to approximately three times more likely to develop the condition than people without diabetes.
When food and saliva mix with bacteria, plaque is formed (a soft, whitish deposit that sticks to the surface of the teeth). If this isn’t removed properly with brushing, it gets hard and forms tartar (or calculus), which can only be removed by a dentist.
A build-up of plaque is the main cause of bad breath and tooth decay, which is when holes form in the surface of the teeth (the enamel). When plaque builds up under the gum line it can also cause gum disease. If this isn’t treated, the plaque may eat away at the bone underneath, which may result in losing the tooth.
Oral problems can occur in people with diabetes for a number of different reasons (see below), which is why it is especially important to visit a dentist regularly and tell them about your diabetes.
Q: Why are people with diabetes more likely to suffer from dental health problems?
A. People with diabetes who have regular high blood glucose levels are more likely to have dental problems. There are several possible reasons:
- An increase in sugars (due to high glucose levels) in gingival fluid (fluid between teeth and gums) can lead to an increase in dental cavities.
- High blood glucose levels can cause dehydration, which leads to a decrease of saliva in the mouth. This can cause an increase in plaque and tartar, which in turn can lead to gum disease.
- Long-term high blood glucose levels can cause the narrowing of blood vessels to gums, which can lead to reduced blood supply, causing increased rate of infection.
It is therefore especially important for people with diabetes to take care of their teeth and gums and have regular check-ups. Your dentist will recommend how frequently to visit. You should tell your dentist that you have diabetes and find out if you’re going to have any treatment that means you can’t eat or drink for a few hours afterwards, as you may need to alter your diabetes medication. Ask your healthcare team for advice on this.
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Q. What should I watch out for?
A. If you notice any of the following, see your dentist straight away:
- Bleeding gums after cleaning your teeth or eating, or bad breath – this could be the start of gum disease.
- Toothache – this is a later sign of tooth decay. There aren’t any obvious early signs, but your dentist might pick up a cavity by doing an examination or X-ray.
- A white or red patch in your mouth or an ulcer that hasn’t cleared within three weeks – this could be mouth cancer.
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Q. Does everyone pay for NHS dental care?
A. Having diabetes may mean that you need to visit the dentist more often, but you will still have to pay for NHS dental treatment unless you are:
- under 18 or under 19 and in fulltime education
- pregnant, or have had a baby in the 12 months before treatment starts
- receiving either Income Support, Income-based Jobseekers Allowance, Income-related Employment and Support Allowance, or Pension Credit Guarantee Credit
- named on, or entitled to, an NHS tax credit exemption certificate
- named on a valid HC2 (full help with health costs) certificate.
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Q. How much does NHS dental treatment cost?
A. Costs depend on the level of treatment you need and vary between each UK nation. Contact the NHS or check online (see below) for a breakdown of costs.
Q. Is it easy to find an NHS dentist?
A. NHS dental treatment is available to everyone, but you’ll have to find an NHS dentist with capacity to see you, and there may be a waiting list. Contact the NHS to find a dentist in your area:
England – call 0845 4647 or visit www.nhs.uk.
Wales – call 0845 4647 or visit www.nhsdirect.wales.nhs.uk.
Northern Ireland – call 028 9032 4431 and ask for the dental branch of the Central Services Agency or email dental@csa.n-i.nhs.uk. Alternatively, visit www.healthandcareni.co.uk.
Scotland – call 0845 424 2424 or visit www.nhs24.com.
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