If you have diabetes, keeping blood sugar in a normal range is important for overall health. High blood sugar levels over time can lead to damage of the eyes, kidneys and circulation.
That’s why it’s so important to have regular visits with your doctor — and your dentist.
Oral health screenings
There is a direct link between oral health — specifically, periodontal disease — and diabetes.
Periodontal diseases are infections of the structures around the teeth, including gums, ligament and bone.
“Inflammation is the link between the physical health of a patient with diabetes and their oral health condition,” says Alexa Jett, dental hygienist and Jackson Care Connect oral health integration manager. “When there are increased bacteria in the mouth and the gum tissue becomes inflamed, it causes a chain reaction throughout the body.”
The effects of this inflammation can contribute to cardiovascular disease, rheumatoid arthritis, obesity, cancer, osteoporosis, respiratory disease and diabetes mellitus.
“It goes both ways,” says Sherry Edwards, DDS, CareOregon dental director. “The infection in the mouth can cause a spike in blood sugar so that you won’t have a healthy blood sugar test. And if your blood sugar is high, as it is with diabetes, that can make your gum disease worse.”
In her practice as a dental hygienist, Alexa could be alerted that a patient might have uncontrolled diabetes by the condition of their gums.
If you have periodontal disease, certain types of dental cleanings — which depend on the diagnosis — may actually improve your blood sugar control. They could mean a .4 percent reduction in A1C, the blood test that provides information about average levels of blood glucose—sugar—over the prior three months. Since “normal” is below 5.7, a 0.4 reduction can be significant. Coupled with medication, weight loss and improvements in exercise and diet, that dental cleaning can really help reach the goal of controlling diabetes.
That’s why the Coordinated Care Organizations that oversee the Oregon Health Plan (Medicaid), like Jackson Care Connect, are making an extra effort to raise awareness of the importance of oral health among members and physical health care providers.
Our dental team is reaching out to primary care providers to share this knowledge.
“We are promoting dental health, and explaining it is part of the package that should be presented for diabetes care,” Alexa says. “In this case, it is not dental care, it is diabetes care.
“Establish a relationship with a dentist, have the annual exam, and develop an oral health treatment plan.”
The Oregon Health Plan covers comprehensive oral health care, including exams and cleanings, in addition to fillings and other repair work.
If you have diabetes, your regular visit to your physical health care provider should include screening for:
- A1C – a long-term measure of blood sugar level.
- Vision – uncontrolled diabetes causes changes in the retina or excess fluid, which results in blurred vision. This requires a special eye exam.
- Kidneys – high blood sugar makes kidneys work extra hard, and damage to blood vessels also hurts kidney function.
- Feet – diabetes can damage circulation and nerve endings, causing some people to stop feeling heat or cold. People can get ulcers on their feet when this happens.
Here are some tips about how to prepare for that annual exam:
- Keep a blood glucose log and bring it with you.
- Keep your list of medications and supplements, both prescription and over-the-counter, up to date. Jackson Care Connect and CareOregon provide a free tool to help you keep track. It’s called the MEDS Chart, and you can download a copy at http://bit.ly/CO-Rx-020819-MEDS-Chart.
- Write down any symptoms and questions you have.
- Be prepared to talk about the results of any screenings you’ve had, and ask about any you should have.
- Talk about your treatment and daily routines, such as food and exercise, and ask if there are any changes you should make to improve your screening test numbers.