Diabetes mellitus is a syndrome of abnormal carbohydrate, fat, and protein metabolism. It is characterized by increased blood glucose levels (hyperglycemia) due to reduced uptake of glucose by the body’s cells, which results either from decreased secretion of the hormone insulin by the pancreas or from reduced cellular sensitivity to the action of this hormone. Diabetes causes numerous acute and chronic complications that significantly affect patients’ quality of life and, if left untreated, may lead to death.
There are several types of diabetes:
- Type I diabetes (or insulin-dependent diabetes), which results from insufficient insulin production by the pancreas due to destruction of the specialized pancreatic β-cells that produce insulin, and primarily affects younger individuals.
- Type II diabetes (or non–insulin-dependent diabetes), which is caused by inadequate insulin production by the pancreas. It accounts for approximately 80% of cases and occurs at all ages, mainly in adults.
- Gestational diabetes, which appears for the first time during pregnancy, resembles type II diabetes, and occurs in approximately 3–5% of pregnancies.
The main symptoms of the disease include polydipsia (excessive thirst), polyuria (especially during nighttime hours), polyphagia (accompanied by weight loss rather than weight gain), pruritus, frequent fatigue without significant physical exertion, delayed wound healing, and recurrent inflammation and infections. Diabetes also has broader effects on various organs and systems of the human body, such as the heart, blood vessels, nerves, kidneys, and extremities.
The diagnosis of diabetes is the responsibility of a specialized endocrinologist. The diagnostic criteria established for diabetes mellitus generally include the following:
- Presence of classic symptoms of diabetes and a random blood glucose level > 200 mg/dl.
- Fasting blood glucose level > 126 mg/dl (measured after at least 8 hours of fasting).
- Sugar curve > 200 mg/dl (blood glucose level measured 2 hours after oral administration of 75 g of glucose).
- A useful marker, although not used for the diagnosis of diabetes but rather for monitoring blood glucose regulation, is glycated hemoglobin (HbA1c). HbA1c values below 6% are considered indicative of good glycemic control.
Diabetes mellitus presents significant oral manifestations. The primary cause of these manifestations is the reduced defensive capacity of the body against oral microorganisms, due to elevated blood glucose levels. The most important oral manifestations of diabetes include:
- ORAL DISEASES AND INFECTIONS, such as fungal infections of the oral mucosa and tongue, oral lichen planus, and angular cheilitis.
- ULCERATIONS of the oral mucosa.
- XEROSTOMIA (dry mouth), meaning reduced saliva production, which leads to loss of saliva’s protective effect on teeth and oral mucosa, destruction of the hard tissues of the teeth, and ultimately an increased risk of dental caries, as well as difficulties in chewing and swallowing.
- BURNING SENSATION, an intense feeling of burning in the tongue and the oral cavity in general.
- HALITOSIS and/or acetone breath odor.
- REDUCED WOUND HEALING CAPACITY following tooth extractions and other surgical procedures in the oral cavity.
Early diagnosis and therapeutic management of the oral manifestations of diabetes are the responsibility of the dentist, who, as the Physician of the Oral Cavity, will thoroughly investigate the symptoms and complications of diabetes affecting the mouth. Regular dental visits every six months contribute to early detection of diabetic oral symptoms, their prevention, and ultimately faster treatment.
If you notice any of the following symptoms, contact your dentist immediately:
- Bleeding of the gums (either during brushing or spontaneously)
- Pain, redness, swelling of the gums
- Gingival recession, causing teeth to appear longer or more yellow at the root
- Burning sensation
- Bad breath
- Tooth mobility
- Changes in the bite (the way the upper and lower teeth come into contact)
DO NOT FORGET
Inform your dentist if you have diabetes.
It is important for your dentist to be aware of this in order to appropriately tailor your treatment plan.
Visit your dentist every six months for an oral health check-up.
Examination of the oral cavity by the Dentist helps prevent serious diseases of the oral mucosa, teeth, and jaws.
Brush your teeth twice daily with a soft toothbrush and fluoride toothpaste. Use dental floss daily.
Maintain a healthy diet and exercise daily.
Sources:
World Health Organization – Global Health Observatory
International Diabetes Federation
Hellenic Endocrinological Society
Council of European Dentists
