India holds the unfortunate distinction of being the “Diabetes Capital of the World” and it’s a tag the nation would do well to drop. Nearly 80 million Indians are said to be under the disorder’s grip, with 1 in 2 citizens unaware that they even have the condition. Obesity, diets high in fats and sugar, a genetic predisposition towards diabetes and a general lack of awareness are all accepted as factors behind these statistics.
Along with these well-known causes, however, there’s another crucial determinant that needs close attention from both healthcare experts and the general population: the link between diabetes and oral health.
But before getting into the specifics of how this bidirectional relationship works, let’s take a quick look at what diabetes is and how it manifests itself in the body.
Type 2 diabetes is the most common form of diabetes. Simply put, it is when the sugar (glucose) level in your blood rises. This rise takes place when insulin, a hormone made by the pancreas, fails to get the glucose from the blood into the cells for energy. If left uncontrolled, diabetes can harm our nerves, kidneys, eyes, heart, and mouth, leading to symptoms like excessive hunger, blurry vision, tingling feet, uncontrollable urination, and dry mouth etc.
Along with neuropathy, nephropathy, retinopathy, and micro-and macrovascular diseases, experts have deemed periodontal disease the sixth complication of diabetes.
WHAT IS PERIODONTITIS?
Periodontitis is an infection caused by plaque, a sticky film of bacteria and other microorganisms attached to teeth. The complication affects the bones that support our teeth, damaging the tissue and causing gum shrinkage and tooth loss. It is controllable but when left unchecked, can be devastating for our oral health.
It is now known that periodontitis has a bidirectional relationship with diabetes. What does it mean? Basically this: by controlling periodontitis, you can help keep diabetes in check and vice versa. In other words, this two-way link means diabetes increases the risk for periodontitis… and periodontal inflammation negatively affects glycemic (or glucose) control.
Along with diabetes, periodontitis is quite common in India too. As per reports from the Ministry of Health and Family Welfare, it affects up to 85% of the country’s population!
So how can diabetics manage their condition and stay clear of this debilitating gum disease? It isn’t all that complicated. Along with a healthy diet and exercise, efficient dental care can go a long way in helping them keep their blood sugar levels in check.
DENTAL CARE FOR THE FIGHT AGAINST DIABETES
Oral health simply cannot be overlooked in the quest to control diabetes and its effects. There are numerous ways that diabetics can maintain a healthy mouth and prevent plaque from damaging their teeth and gums. Plaque forms when sugary foods like soft drinks, bread, fruit etc interact with the bacteria in our mouth.
Brushing twice a day and rinsing the mouth well after every meal does wonders for our oral health. These are foundational, everyday practices that must be followed by each one of us. For diabetics, flossing the teeth once a day is also recommended. So is the use of anti-microbial and anti-inflammatory toothpaste. Additionally, rinsing teeth every 1-2 hours can also help maintain oral hygiene. And of course, smoking remains a strict no-no.
It has been suggested that diabetics must visit a dentist every 3 months so that any early sign of periodontitis can be detected. The patient must also report any symptom of gum disease as early as possible — something that is recommended for non-diabetics and/or people with such a genetic background too. Reporting symptoms is especially important because there have been numerous instances of dentists diagnosing diabetes!
THE NEED FOR AWARENESS
Along with the general population, India’s healthcare professionals also need to be more aware on this link between diabetes and oral health so that early diagnosis can be done, and precautionary measures may be suggested. Non-dental care specialists must also be trained and educated on the importance of oral hygiene and upkeep.
A 2014 survey reported that around half of all Indians did not use a toothbrush or toothpaste. What India also needs is more outreach programs that inform the millions of citizens residing in remote, rural and other areas about the need for dental care. India would also do well to make affordable dental care products available so that more citizens are able to access them. The fight against diabetes is taking place on many fronts. However, dental care has long been overlooked as a possible contributing solution. It’s time to change that.
The author is a BDS, MDS – Periodontology and Oral Implantology on Dental care for Diabetics.