Individuals suffering from type 1 and type 2 diabetes are at risk of developing dry mouth syndrome, also called xerostomia. Abnormal insulin production and/or absorption rates, which occur in diabetes, can cause the salivary glands to not release adequate amounts of saliva.
Patients with xerostomia often have difficulty with many aspects of eating and swallowing. Denture wearers with diabetes may develop sores or have problems keeping dentures comfortably in place. In addition to dry mouth, many people with diabetes can experience taste disorders, excessive thirst, or a painful tongue.
When xerostomia is not adequately treated, oral hygiene is severely affected and can frequently cause:
- Cracking and inflamed lips
- Chronic mouth lesions and/or tongue ulcerations
- Dental cavities, tooth abscesses, and dental pulp infections
- Severe bad breath exacerbated by diabetic conditions
- Oral candidiasis (oral thrush)
- Infection of the salivary glands
- Thick saliva
- Difficulty swallowing
- Loss of smell and taste
Dental decay and dry mouth start when different types of anaerobic bacteria adhere to tooth enamel, the tongue, or the back of the throat – places where oxygen is negligible. Extremely high amounts of sugar-based acids are produced by these bacteria, leading to accelerated rates of dental decay and gum disease.
Research shows that xerostomia associated with parotid gland enlargement affects nearly 25% of patients suffering from moderate to severe type 1or type 2 diabetes. The parotid gland is the larger one of the two salivary glands, responsible for releasing saliva into the mouth.
Type 1 diabetes, once called juvenile-onset diabetes, is a chronic disease that predominantly affects individuals ages 25 and younger. It is often caused by an autoimmune reaction in which the body’s defense system attacks the cells that produce insulin. For reasons that are still not fully understood, people with type 1 diabetes produce very little or no insulin and therefore require daily insulin injections.
Type 1 Symptoms
- Excessive hunger and thirst
- Frequent urination
- Weight loss
- Tingling in the feet and hands
- Blurry vision
- Weight loss, even though you are eating more
- Lack of interest and concentration
- Frequent infections
- Slow-healing wounds
Type 2 diabetes
In type 2 diabetes, the body’s muscle cells, fat, and liver respond abnormally to insulin, a condition referred to as insulin resistance. When this occurs, blood glucose (sugar) cannot reach the cells that normally store the glucose used by the body as an energy source. As a result, high sugar levels accumulate in the blood, creating a condition called hyperglycemia. Although people with type 2 diabetes can often initially manage this condition, after a period of time, many rely on oral medications or insulin. The disease often goes undiagnosed for years since the symptoms are often not as obvious as in type 1.
Type 2 Symptoms
- Chronic fatigue
- Increased hunger, thirst, and urination
- Infections and/or wounds that heal more slowly than usual
- Numbness in the hands or feet
- Blurry vision
The longer one has diabetes, especially if left untreated, the more potential the disease has to wreak havoc on the entire body. Lack of awareness about diabetes, combined with insufficient access to health services, can lead to complications that impact the heart, blood vessels, eyes, kidneys, nerves, as well as oral health.
Why Does Diabetes Cause Dry Mouth?
According to Dr. Leigh Anderson of the University of the Pacific Arthur A. Dugoni School of Dentistry (www.dental.pacific.edu), experimental trials have resulted in evidence that insulin abnormalities have indirect and direct effects on the function and structure of salivary glands. This may be attributed to the unhealthy impact that unstable blood glucose levels have on the salivary glands’ ability to release adequate saliva into the mouth.
People with diabetes have oral diseases in large part due to dry mouth. However, the small amount of saliva secreted by the parotid glands contains excessive amounts of unabsorbed glucose, which further contributes to the deterioration of teeth, gums, and overall oral health. Bacteria thrive in this sugary, dry, anaerobic environment.
Gingivitis causes the gums to become red, swollen, and bleed easily, but there is usually very little or no discomfort. This condition is often caused by dry mouth, but is reversible with professional treatment and good oral home care. However, when gingivitis is left untreated, it can progress to more serious periodontal disease, also known as periodontitis. Many patients suffering from xerostomia and diabetes will develop periodontal disease.
Periodontitis (also called “pyorrhea”), is a serious inflammatory disease affecting the gum tissues surrounding teeth. Over time, plaque caused by bacteria calcifies and pushes down between the gums and the dental roots, causing the formation of periodontal pockets. These pockets are so deep that they cannot be cleaned out without professional help. Advanced periodontal disease may also affect bone growth, inhibiting the ability to bite, chew, and talk properly. In advanced cases, surgery is often needed to correct serious malformations of the jaw that may provoke other health issues.
Tips to Prevent Dry Mouth and Periodontal Disease Caused by Diabetes
People with diabetes can reduce or eliminate xerostomia by carefully checking glucose intake, eating the right foods, taking medication as directed, maintaining a healthy weight, and regularly monitoring insulin levels. The following daily activities can help keep the mouth clean and hydrated:
- Brush twice a day with a toothpaste containing fluoride
- Floss after every meal
- Use mouthwash that is free of alcohol, saccharin, or foaming detergents like sodium lauryl sulfate
- Drink plenty of water
- Eat more vegetables and fruits
- Avoid sugary and caffeinated beverages
- Scrape the tongue with a professional tongue scraper
- Chew gum or suck on mints containing xylitol, a known breath freshener
Unfortunately, the majority of over-the-counter oral hygiene products contain ingredients that actually promote bacterial growth, bad breath, and even tooth decay. Alcohol based mouthwashes make the mouth very dry, which will actually exacerbate the problem. Saccharin is a taste enhancer that does not decrease dry mouth or bad breath. Sodium lauryl sulfate is found in detergents and soaps, but does nothing to prevent bad breath and may facilitate the formation of canker sores.
When the mouth is properly hydrated and free of food debris, the potential for gum and dental disease is greatly reduced. TheraBreath oral hygiene products contain natural yet powerful ingredients that directly target xerostomia symptoms and the bacteria that proliferate in dry conditions. TheraBreath toothpastes, mouthwashes, and sprays effectively kill bacteria and help increase the flow of saliva. They can help freshen breath and eliminate dry mouth, even for people suffering from a chronic illness like diabetes.
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