By: Patrick Totty
Despite incredible advances in dental technology over the past 50 years, many people still dread visits to the dentist-enough to put off going even when their teeth are throbbing with pain and their gums are oozing blood.
That second condition, bleeding gums, is of particular importance to people who have diabetes. Because diabetes reduces the body’s resistance to infection and inflames tissues, gums can easily become infected. The resulting disease, periodontitis, begins with redness, swelling, and bleeding. Even simple flossing or vigorous brushing can be enough to start blood flowing.
Left untreated, gum disease can lead to tooth loss and even the need for surgery to clean out infected pockets under the gums and reconstruct what’s left of the tissue. Periodontitis also creates a “gateway” condition where disease-causing agents can more easily enter the body. Because diabetes slows healing, not only the gums but other parts of the body are subjected to infections that take a long time to cure.
Another concern is that researchers think bacteria and inflamed gum tissue produce chemical changes in the body that can lessen the effectiveness of insulin. As a result, blood sugar levels can increase, leading to a vicious circle in which higher blood sugars create gum inflammation, which leads to higher blood sugars.
Even so, there’s a bit of good news: periodontitis can be treated, even reversed. But two steps are necessary for that to happen: 1.) You have to maintain lower blood sugars to reduce inflammation, and 2.) you must schedule regular dental examinations, including routine teeth cleaning.
But let’s assume that you’re already doing all you can to keep your blood sugars low. That makes focusing on gum health a priority.
While the standard recommendation is that you should get your teeth cleaned twice each year, for people with diabetes, the recommendation is four times per year-once every 90 days. The reason for the increased frequency is so that your dentist can monitor and remove plaque buildups that harbor infectious bacteria.
He or she may supplement teeth cleaning with a specially formulated mouth rinse, such as chlorhexidine gluconate, which works to reduce gum swelling and bleeding. Other recommendations may include using a sonic electric toothbrush to assist in knocking food particles from between the teeth and at the gum line, as well as the usual advice to floss.
But the problem for many people is getting to the dentist’s chair in the first place. However, there are some comforting pointers that may make it a bit easier for you to get there:
1. Teeth cleaning doesn’t require drilling or the use of Novocain or anesthesia. (The exception is gum surgery, which is a whole other topic.) While the dentist has to use sharp instruments to probe beneath the gum line and to scrape off plaque, at worst they are uncomfortable. Discomfort aside, it is highly unusual to experience deep or lasting pain during a tooth cleaning.
2. There will be some bleeding. Typically your dentist will work your teeth in four segments, starting with either the top or bottom teeth, front and back, then moving on to the opposite set, front and back. At the end of each segment of work, your dentist will ask you to rinse. This is when you might see a lot of blood as you spit into the chair-side sink. While nobody likes to see his own blood, this isn’t a bad thing. It confirms that you were right to come to the dentist because your gums easily bleed, and it shows that you’re taking the right step to remove the plaque that inflames them.
3. If you haven’t had your teeth cleaned in a long time, your first tooth cleaning session with a dentist might take an hour or more. But once you develop the habit of regular teeth cleaning, an efficient dentist can complete the job in about 30 to 40 minutes.
4. Your gums may feel tender for awhile after a cleaning. This doesn’t last too long, and it’s rare for a dentist to tell you to refrain from eating soon afterwards. One of the nice things about freshly cleaned teeth is the smooth feeling you get when you run your tongue over them. The cleaning has removed all surface film and gunk, and you can feel the difference.
5. Be aware that you’ll probably tense up during the procedure. This is a normal human reaction-after all, somebody is rummaging around in your uncomfortably wide-open mouth with strange metal instruments. So it’s no surprise that you may feel your leg, arm, and shoulder muscles bunching up as though they’re waiting for something bad to happen (which it won’t).
This is when you want to make a conscious effort to relax them, which you’ll probably be able to do for a bit. But unless you’re a master meditator or yogi, the chances are good you’ll tense up again. No problem-the goal here is to remind yourself to be aware that you can relax, and then do it as much as possible when you think about it.
Your muscles will appreciate the temporary relief, and you’ll teach yourself that it’s possible to sit in a dentist’s chair at least part of the time without worrying that something dreadful is about to happen.
6. Music can help to relax and distract you. Ask your dentist is he or she minds you wearing earphones during your cleaning. If your dentist prefers you don’t, it’s reasonable to ask what kind of music-if any-you’ll hear in that particular office. Whatever kind of music you listen to, make sure it’s soothing. That usually means no “1812 Overture,” or heavy metal, or an infectious I-must-get-up-and-dance salsa. (There are exceptions; just know yourself.)
Is going to the dentist a pleasant task? For most of us, not really. Will getting your teeth cleaned regularly lower your blood sugar? Probably. Is dental health an essential part of taking the best care of yourself as you manage your diabetes? Definitely yes.