Why is this important?
- Gum disease is common, seriously affects diabetes, CVD, CKD and is treatable.
- The higher the blood glucose, the greater the risk for developing gum or (periodontal) disease.
- Infection and inflammation associated with gum disease is systemic, so that treatment has benefits throughout the body.
- AI/AN people with diabetes have two to three times more advanced gum disease than people who do not have diabetes.
- 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.
- Other oral health issues in people with diabetes, such as cavities, problem with dentures, mouth sores, and dry mouth need referral to a dental provider.
- Oral care is an integral part of diabetes care, reducing CVD and CKD, and requires a team approach to overcome barriers to accessing care.
Recommendations for Oral Care
- Examine the patient's mouth as part of routine diabetes care:
- Examine teeth and gum for plaque, gingival inflammation, and caries.
- Inquire about pain and look for problem 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 tobacco cessation.
- If a patient smokes, refer for smoking cessation. Smoking is a significant risk factor in the development of gum disease.
- 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.