Dr. Rafif Tayara D.D.S, C.S.S
American Dental Clinic, Dubai, UAE
Advanced American Dental Center, Abu Dhabi, UAE
Dental Kingdom, Cedars Dental Center, Doha, Qatar
Diabetes type 1 is a disease in which the body does not produce insulin, resulting in a high level of sugar in the blood. Diabetes type 1, the most common type of diabetes in children affects 1 in 400 to 600 children and adolescents. Pediatric dentists play a major role part of an allied health team in providing oral care to children with diabetes. As such, they may detect undiagnosed cases of diabetes and refer patients to physicians for further evaluation.
Oral Complications of Diabetic Patients
The oral complications of uncontrolled diabetes mellitus are devastating. These may include gingivitis and gum disease; xerostomia (dry mouth) and salivary gland dysfunction; increased susceptibility to bacterial, viral and fungal (that is, oral candidiasis) infections; caries; abscesses; loss of teeth; taste impairment; and burning mouth syndrome.
Gingivitis and periodontal disease or gum disease, often called the “sixth complication of diabetes mellitus”, is the most common oral complication of diabetes. Well-controlled diabetic patients, as measured by blood glycated hemoglobin levels, have less severe gum disease than poorly controlled diabetics.
An increase in the rate of dental caries has been also reported in young patients with diabetes and may relate to salivary dysfunction. Oral candidiasis occurs more frequently in diabetics than in non-affected populations, because of altered response to infections, xerostomia and an altered oral flora.
What we may find:
- Increased risk of dental caries
- Burning mouth or tongue
- Gingivitis with high risk of periodontal disease
- Xerostomia (dryness of mouth)
- Poor wound healing/ surgical wound infections
- Taste alteration
- Acetone breath
- Oral candidiasis (fungi)
Day of Dental appointment
- Schedule a morning appointment
- To help make sure your child’s diabetes is under control before the dental appointment, make sure your child has: 1- eaten a meal, 2- taken his medicine.
- Bring a list of all medicines your child takes.
- Share with the dental staff the most successful way to talk or communicate with your child. Suggest things that make your child feel good.
- Bring a list of any questions you may have about your child’s teeth.
- Tell the dentist you would like to talk about any treatment before it is done.
- Ask whom you should call, or where you should go, if your child has a dental problem and the dental office is closed.
Prevention Is Key!
Before you see teeth in your baby’s mouth, start wiping his gums with a wet cloth or a finger toothbrush: good habits start early!
Follow a daily plan to take care of your child’s teeth: brush teeth twice a day with fluoride toothpaste. If your child doesn’t like a toothpaste flavor, it may be helpful to try different toothpastes until you find one your child likes.
Bring your child to the dentist for exams and cleanings twice a year. Ask the dentist for dental “sealants” and fluoride treatment to protect your child’s teeth from tooth decay.
“Good oral hygiene and frequent checkups with the dentist are extremely important for the patient with type 1 diabetes.”
Healthy Food And Healthy Habits Are Teeth-Friendly!
- Ask your doctor or nurse for prescriptions without sugar to help prevent tooth decay (also called “cavities”). Use “over-the-counter” medicines that do not have added sugar.
- Encourage your child to rinse with water after taking medications that may cause “dry mouth”. A dry mouth can make it easier for your child to get tooth decay.
- Avoid offering your child sugary snacks and drinks (juices, pop) and avoid using them as rewards. Look at labels on food products for words ending in “ose” such as “fructose” & “sucrose” and limit their use.
- Do not serve juice in sippy cups, just in open cups. If you need to put a child to bed with a bottle, fill it with water only.
- Do not share utensils, cups and toothbrushes with your child to avoid passing the bacteria, which can cause tooth decay. If your child uses a pacifier, do not dip the pacifier in honey or sugar.