Diabetes and Oral Health

Diabetes and Oral Health

Diabetes is a metabolic disease that primarily concerns carbohydrates, protein and fat metabolism. Diabetes is a chronic metabolic disease that increases blood sugar levels and can cause damage to important organs such as kidney, heart and eyes due to changes in vessels and nerves. It shows itself by the constant high blood sugar.

The main metabolic disorder in diabetic patients is the inability of glucose (sugar) transported through the blood to enter the cells. Under normal circumstances, glucose, which is obtained from foods or released into the blood from the stores in the liver, enters the cell with the help of the insulin hormone secreted by the pancreas and is burned there and transformed into energy.

The most common change in the mouth in diabetic patients is dry mouth. Dryness, burning, taste disturbance occurs in the mouths of uncontrolled diabetics. In addition, with the increase of glucose in the salivary glands and gums in the mouth, the bacterial flora living in the mouth is affected, and accordingly, fungal infections, gingivitis and inflammation of the tissues surrounding the tooth (periodontitis) are common. It is known that the risk of all bacterial infections increases in diabetes.

Is there a relationship between gum disease and diabetes?

Most of the approximately 21 million Americans with diabetes are surprised when they hear of an unexpected complication with their gums. Studies have shown a high incidence of gum disease among people with diabetes, and gum disease has been added to the list of other diabetes-related complications such as heart disease, stroke and kidney disease.

Well, “everything is mutual”?

New studies reveal that the relationship between gum disease and diabetes is mutual. Both people with diabetes are more prone to gum disease, and gum disease has the potential to affect blood sugar control and contribute to the progression of diabetes. Studies show that people with diabetes have a higher risk of oral health problems such as gingivitis (early gum disease) and periodontitis (severe / established gum disease).

People with diabetes have an increased risk of gum disease because they are generally more susceptible to bacterial infection and have reduced ability to fight bacteria that invade the gums.

The regularly published United States Department of Health Oral Health Report states that good oral health is an important part of overall health. Therefore, be sure to brush your teeth properly, floss your teeth and go to your dentist for regular check-ups.

Diabetes and Dental Implant

What are the Oral and Dental Problems That May Occur in Diabetes? How Should it be Solution and Prevention?

Daily dental care and periodic dental exams are an integral part of maintaining general body health. Oral and dental symptoms may indicate diabetes. Every year, a significant number of new diabetes is recognized by dentists. Uncontrolled diabetes can adversely affect oral and dental health as well as organs such as heart, kidney and eyes. Oral and dental problems that can be seen in people with diabetes include:

  • Dry Mouth
  • Fungal infections in the mouth, thrush
  • Gingival diseases
  • Dental caries

Dry mouth; It is the disappearance of the effect of saliva washing the teeth and facilitating chewing due to the darkening of the saliva and the decrease in the amount of saliva in patients with diabetes. Low saliva can lead to the development of plaque by sticking to the tooth surface of food and then the formation of tartar. Dry mouth may cause the patient to feel pain, delay the healing of wounds and increase inflammation and loss of teeth as a result. If dry mouth cannot be prevented, the mouth should be rinsed frequently or artificial saliva preparations recommended by the dentist can be used.

Diabetic patients are susceptible to fungal infections in the mouth due to the high sugar in their saliva. This problem manifests itself in cracks and redness at the joints of the lips. Smoking and not removing prostheses from the mouth at night can accelerate fungal growth. Medicines are used in the treatment of fungal infections in the mouth. Care should be taken to clean the prostheses and must be removed at night. Smoking should not be used

Since high blood sugar level causes thickening and congestion in blood vessels, the nutrition of tissues is negatively affected as the oxygen carrying capacity of the blood decreases. This causes the gums to separate and recede from the teeth.

Small pockets formed between the tooth and the gum over time allow the development of new bacteria foci and the event progresses to tooth loss. During this process, the patient feels pain and shaking in the teeth, bleeding in the gums and bad smell in the mouth. Oral inflammations, which can often accompany these events, make sugar control difficult and the event becomes a vicious circle. Advanced gingivitis can only be cured by surgical intervention.

In diabetic patients with uncontrolled blood sugar, high sugar level in saliva invites bacteria and bruises easily occur.

Suggestions for Diabetes Patients on Oral and Dental Health

In order to prevent gum disease, first of all, a good sugar control and regular oral care are necessary.

Teeth should be brushed at least 2 times a day for 2 minutes. Due to the presence of snacks in diabetics, the number of brushing may need to be increased. A soft brush should be used. The top of the tongue should also be brushed.

Flossing should be used at least once a day to remove bacteria between teeth. After the procedure, the mouth should be rinsed with water and the gum should not be pressed too much while the dental floss is placed between the teeth.

In cases with common caries and gum problems, the dentist should be consulted.

In order to protect oral health, in addition to brushing teeth and using dental floss, it is necessary to go through a dentist check every six months.

Does Diabetes Prevent Tooth and Gum Treatments?

Diabetes itself and the use of insulin do not constitute an obstacle or danger for oral interventions. Diabetics can easily take antibiotic treatment if necessary.

It is necessary to have a health check before serious dental interventions in patients with poorly controlled diabetes. If blood sugar is high due to bleeding and infection, tooth extraction and gum interventions should be done after sugar control, if possible.

In Which Case Should You Consult A Dentist With Diabetes?

Gingival bleeding during brushing or eating,
Redness, pain, tenderness, swelling in the gums,
Receding gums,
Dental stones,
Sensitivity in teeth,
Changes in position and wobbling in teeth,
Bad smell and taste in the mouth,
Tooth decay

In diabetic patients; It will be easier and more enjoyable to maintain oral health and live with your own teeth with controlled nutrition, regular medication use, non-negligent mouth cleaning and dentist controls.

If I Have Diabetes, Am I At Risk For Gum Problems?

If your blood sugar levels are not well controlled, you are at a higher risk of developing gum disease and losing teeth than non-diabetics. As with all infections, gum disease can be a factor in high blood sugar and can make diabetes control difficult.

Other oral problems associated with diabetes include: thrush, the type of infection caused by a fungus growing in the mouth, and dry mouth that can cause ulcers, infections, and bruises.

What Can I Do to Prevent Diabetes-Related Dental Problems?

First of all, check your blood sugar level regularly. Take care of your teeth and gums and go to your dentist for regular check-ups every six months. To control thrush, which is a fungal infection, maintain good diabetic control, avoid smoking, and remove and clean your dentures every day, if you have them. Good blood sugar control can also prevent or alleviate dry mouth caused by diabetes.

What Can I Expect During My Check? Should I Tell My Specialist Dentist About My Diabetes?

People with diabetes have special needs and your dentist is well equipped to meet these needs with your help. Notify your dentist of any changes in your condition and any medication you may be taking. Postpone non-urgent dental procedures if blood sugar is not well controlled.

Do you know that Type 2 Diabetes Disease can be treated surgically?
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sleeve gastrectomy

Sleeve Gastrectomy is not risky as thought

Sleeve gastrectomy is the most risk-free type of surgery in obesity surgery with 10-year results. The important thing is which team performed the surgery and which patient.

There are many positive as well as negative news about obesity surgeries in the press. So, how is it decided what kind of surgery will be applied to which patient, is tube stomach surgery a risky method as claimed?

How many types of surgery are there to solve the obesity problem?

The most common obesity surgery in the world is the ‘sleeve gastrectomy’ surgery known as sleeve gastrectomy. Like most of the world centres, we prefer tube stomach surgery in patients who have not had any obesity surgery before.

Bypass methods, in which the small intestines are also involved, are still very important initiatives in some special cases. The ‘duodenal-switch’ intervention in super   obese patients with a body mass index above 60, and stomach-by-pass for those who regain weight after the tube stomach are the operations we are currently applying.

The duodenal switch method can be the first choice in patients with advanced obesity, where Type 2 sugar is very prominent and using insulin. Because this initiative has a more direct effect on diabetes.

Permanent Method That Saves Lives

Can you evaluate the types of surgery performed in obesity surgery with their pros and cons? In fact, there is a range of options that vary according to the patient’s BMI, sugar, age and number of surgery. Our task is to perform the most appropriate surgery for that patient with the most perfect technique.

weight loss in turkey sleeve surgery

In the whole world; Gastric sleeve surgery is the first option for more than %90 of those who will have obesity surgery for the first time. By-pass methods, on the other hand, are more difficult, more risky but still life-saving methods that are still valid especially in second surgeries.

How do you decide which type of surgery to perform on a patient who comes to you with an overweight problem and by looking at which criteria?

The decision of which patient and which surgery will be performed is entirely related to a series of characteristics belonging to the patient and partly to the experience of the surgical team. While the vast majority of patients prefer sleeve gastrectomy first, rarely the first surgery option is a ‘by-pass‘ attempt. For some overweight patients, we may wish to lose a little weight with balloon application or special and short-term diets before surgery.

Often times, even the first conversation and examination we have with our patient in our office can affect our decision on the choice of surgery. “Does the patient have diabetes and is in an advanced stage?”, “How many years and in what dosage has he been using insulin?” The type of surgery is selected together with the patient, considering some factors such as.

It is of great importance to have both a psychologist and a dietician in your body, even at the decision stage.

10 Year Results

In the press, we come across some negative news about those who had tube stomach surgery. Are the negativities experienced after tube stomach surgery caused by the patient, the physician, or the wrong patient selection?

Gastric sleeve surgery is less than one in a thousand, that is, it is an attempt with a very reasonable risk. Even the most risk-free obesity surgery and long-term results of at least 10 years are available. All the negativity in the press is unfortunately unfortunate.

There is a false perception that an aesthetic purpose has resulted in death. On the contrary, sleeve gastrectomy is the safest and risk-free surgery for obesity. On the other hand, obesity surgery is of course the interventions that should be done by special and competent teams who are dedicated to this issue.

Of course, the negativities due to competent and inexperienced teams or physicians can attract attention, but these bad examples should not disturb the morale of morbid obese people who have no cure.

Obesity surgery; should be considered as a whole. In the case of correct patient selection, detailed preoperative preparation, excellent technique, close postoperative follow-up and long-term support to patients with dieticians and psychologists, side effects and negativities are rarely observed.

There is a public discourse about those who underwent sleeve gastrectomy that they started to regain the weight they lost about three years later; is this true.

The answer to this question is both yes and no. First of all, there is no such thing as ‘No surgery cures morbid obesity 100% and you are not able to gain weight again’! Even if it is possible to become morbidly obese again after all surgeries, it is possible. If we open the subject a little bit; after tube stomach surgery, the weight problem is %60-70 likely to end throughout life. %20-30 of patients gains weight again three to four years after surgery, albeit a little.

A group close to % 4 can become morbidly obese again in the long term. For this reason, the number of patients who have a second and even third surgery in obesity surgery is gradually increasing.

Is aesthetic surgery necessary for skin sagging after bariatric surgery?

It is not necessary in any way. However, if desired, plastic surgeons can help with certain procedures. However, these are not essential for health and are only attempts for aesthetic purposes.

Comfortable and happy weight

Is it difficult and painful during and after the operation? Are there any restrictions for the patient?

Pain is never a problem as there are no incisions and operations are performed through millimetres holes. The best part is; People lose weight by dieting comfortably and happily.

Because the appetite is clearly curbed. In other words, new methods make you lose weight by dieting comfortably and happily, not by craving and not being able to eat. The amount of weight loss gradually decreases and stops at the end of a maximum of 1.5 years.