Examine the patient’s mouth as part of routine diabetes care:
Examine teeth and gums for plaque, gingival inflammation, and caries.
Inquire about pain and look for problems, including sores, swollen or bleeding gums, loose teeth, mouth ulcers or growths, candidiasis, or decayed teeth.
If a patient uses oral tobacco, be sure to examine gums and oral mucosa, especially where the patient usually places the tobacco.
Refer for professional dental care:
Annually for routine dental examination.
More often for people with periodontal disease as determined by the dental care professional.
As needed for evaluation of oral health problems.
People with diabetes frequently have problems with their teeth and gums, especially when they have poor glycemic control. The higher the blood glucose, the greater the risk for developing periodontal disease. AI/AN people with diabetes have two to three times more advanced periodontal disease than people who do not have diabetes.
Periodontal disease results in the loss of all teeth in approximately one-third of AI/AN people with diabetes. People without teeth can suffer emotionally and nutritionally because they may not be able to eat many important types of foods. Every attempt should be made to replace missing teeth with dental prosthetics when there is significant loss of chewing function.
Periodontitis can negatively affect diabetes control and development of diabetes complications. The infection and inflammation associated with periodontitis can aggravate blood glucose control and increase risk for many of the complications of diabetes such as CVD and CKD.
In addition to periodontal disease, other oral health issues observed in people with diabetes include: dental caries, burning mouth syndrome and potential difficulty in wearing dental prosthetics, salivary gland dysfunction/dry mouth, fungal infections, lichen planus and lichenoid reactions, delayed healing, and taste disorders.