Effects of Diabetes and Other Hormonal Conditions on Oral Health

Have you noticed how your gums bleed more when you are close to your cycle or pregnant? Are you a teen going through puberty and noticed increased bleeding in your gums? Or did diabetes cause you to lose some or all your teeth? Have you heard of being pregnant and your baby leaching calcium from your teeth and how it increases cavities?

There are noticeable effects on our mouth when there are shifts in hormones. Puberty, menopause, menstrual cycles and diseases like diabetes play a huge role in our oral health. I have heard patients say, "Well, I got a lot of cavities while I was pregnant because my baby stole the calcium from my teeth." This is another misconception of our dental world. Teeth have minerals like calcium laid down like a sidewalk and it is impossible for it to be stolen or taken away. However, they can be broken down from acidic factors like the inflammatory process and sodas. This may have been an explanation that was once used but I believe there is another cause of this increase in caries and tooth loss. Hormonal changes.

When there are shifts in hormones, the body goes crazy in attacking the bacteria in our mouth. It's like the body is saying, "I am going through something right now so I can't have any more bacteria entering into my system." So, they send out the troops (white blood cells) to the front lines, our mouth. AKA the portal to the system. When there is an increase in white blood cell activity in our mouth this is the increase of inflammation. Bleeding, redness and sensitivity is increased. See my blog on "Why do my gums bleed"

Inflammation is an integral part of healing. There is a flurry of activity as the body destroys bacteria, grows new tissues and eliminates wastes from the healing process. However, if it is chronic (long lasting) the effects are very damaging. The by-products (acids and enzymes) created from the body and bacteria themselves, is on overload and it can break down hard and soft tissues, bone and even teeth.

Many people avoid flossing and dental care because of the inflammation already present in their mouth. There have been several occasions that my patient says that they don't floss because it bleeds and hurts. The more one doesn't maintain their mouth, the more bacteria and the more the body fights it. With a lot of acids and enzymes on the soft tissues it can cause them to be very tender, puffy and sore. It's like working out. If you work out the muscles get sore, but if you continue on a regular basis the soreness goes away. If you work out once a month, the muscles will be sore every time you work out. 

In this case, I tell patients to use a peroxide rinse (see recipes) for 3-5 days before starting to floss again to reduce the inflammation. In doing this, it is a less painful and bloody experience. I tell patients flossing with regularity is very important. Movement is life and if things are left to remain stagnant, that's where issues arise. Just like your body, if one is bedridden and cannot move, body sores can form and muscles can eventually atrophy. 36 hours of stagnancy provide the perfect environment for the anaerobic ("bad bacteria") to form and breed. These guys trigger the immune response and then begins the inflammation. 

***Insider tip: Floss Monday, Wednesday, Friday OR every other day. If you go more than 2 days you'll see the bleeding start.

Pregnant patients who already don't floss on a regular basis will see an increase in bleeding and tenderness of their gums. When they cease their flossing and dental care due to pain or even morning sickness, this allows the plaque and bacteria to enter into their systems. This also allows more bacteria to grow in their gums and increase the inflammation. This is due to the shifting hormones that pregnant women go through during pregnancy. Perhaps, the body is attempting to protect the growing life within. Now, what kind of effect does that have on our babies while en utero? I asked patients with moderate to severe gingivitis if they had a low birth weight baby and they have all confirmed that their baby was small or lightweight. We are what we eat. It's not a difficult situation to fathom that our dental health can effects a fetus as well.

I been a part of co-diagnosing diabetes in my young patients. Diabetes is a very manageable condition if caught early. If left untreated it can cause limb loss, blindness and even death. It causes great concern when I see patients being diagnosed with this disease at a younger and younger ages. Especially, when it is type 2 diabetes which is caused by dietary choices. When I assess gum tissues and evaluate x-rays I see a mouth of a 40 or 50 year old in a patient who are only in their 20s. The advanced bone loss and severity of bleeding raises red flags in my head. Why in the world does a 20-something year old patient have so much bone loss? On several occasions, I observed this situation and asked about family background and dietary choices. After confirming that either parent or family member had diabetes and the patient had a high sugar consumption I spoke to patients about getting evaluated for diabetes. Sure enough a few weeks later they returned with a confirmation that their blood sugars were elevated and they were either pre-diabetic or confirmed diabetic. Hormones shift when a patient has elevated blood sugars and increases the reaction of the bacteria in the mouth. It is very evident in observing patients with diabetes that they have an increased rate of periodontal disease and tooth loss.

This is just another link I am observing and confirming in my practice as a dental hygienist. I encourage my patients and the community to consider the effects of their oral health on their systemic health and overall quality of life. The devastating effects take time to manifest. It can take years to decades to develop diseases due to the neglect of oral health. When I was younger, I was told old people get sick. It's not the fact that people are older in years, its the time in which things are building up in our bodies. Then why are my patients who are in their 20s and 30s developing high blood pressure, diabetes, arthritis, and other "old people diseases"? I believe our modern diet is just another facet of our issues. The processing and refined sugars in our foods is not only effecting our gut, but I think it starts in the mouth. (Coming soon: Modern Diet and Effects on the Oral Health) 

The rationalization of age and being old to be the reason for disease is becoming outdated. I have encountered plenty of patients who were well into their 70s to 90s in great health, free of medications and free of debilitating conditions. They retained most, if not all their teeth, ate well and took walks regularly. I believe we can live a long, healthy life free of disease and ailments if we consider all the factors of our health. Eat well, think well, exercise and clean the mouth. Let's prevent things instead of dealing with them when we get there. Best of luck to you all.

"An ounce of prevention is worth a pound of cure." -Benjamin Franklin, 1736