Diabetic Oral Healthcare

Gingivitis is a very common condition. NHS England reports that approximately half of adults in the UK have gingivitis or a more serious form of gum disease. One contributory factor is that carbohydrates are broken down by saliva into glucose and acids in the mouth. If blood sugar levels are high, saliva will have higher levels of glucose, encouraging bacteria to grow and increase the risk of gum damage. If not treated early, gingivitis may develop into more serious forms of gum disease such as periodontitis 1.

Symptoms of gingivitis include:1

• Swelling or inflammation of the gums
• Redness – healthy gums should appear pink
• Bleeding of gums – particularly noticeable following brushing
• Painful gums

What can your community pharmacy do to help?

Pharmacies have patients with diabetes that present prescriptions for medicines each month and they also know about a proportion of the patients who are currently treated with diet alone. A member of the pharmacy team can offer information on oral health. Including:

Checking whether the person with diabetes has sore gums or spits traces of blood after brushing their teeth.
Discussing the importance of looking after your mouth and brushing and flossing regularly and enquiring about the patient’s daily routine.
Smoking makes gum disease worse so discus considering stopping should the patient be a smoker.
Emphasise the importance in visiting the dentist and hygienist on a regular basis.
Advise about reducing the number of acidic and sweetened drinks.

Oral Healthcare Tips:

Use a soft to medium small head tooth brush and replace every three months
Brush at least twice daily using a pea sized blob of fluoride toothpaste (at least 1,350ppm 2)
Brush with a round motion (not up and down) and make sure you reach the difficult to reach parts, like behind the teeth
Regularly floss your teeth
Consider using Chlorhexidine based mouthwash if gums bleed
See your dentist on a regular basis and visit your hygienist
Visit the British Dental Association for more information: www.BDAsmile.org

References:

1. Diabetes UK. Diabetes and Gingivitis. Available from www.diabetes.co.uk
2. British Dental Association. Oral hygiene. Available at www.bdasmile.org