Prediabetes & Oral Screenings

High blood sugar levels provide an ideal environment for bacteria to thrive in the mouth. When one consumes foods and drinks containing sugars and starches, the bacteria in the mouth produce acids that can damage tooth enamel, leading to tooth decay. If tooth decay seems to be progressing rapidly or if a patient is experiencing multiple caries despite good oral hygiene practices, it could be a sign that their blood sugar levels are elevated. This rapid decay can be a warning sign of prediabetes or diabetes.

Gingivitis is inflammation of the gums caused by bacterial plaque buildup along the gumline. High blood sugar levels can weaken the body's ability to fight off infections, including those in the gums. As a result, patients may experience red, swollen, or tender gums, which are characteristic symptoms of gingivitis. If left untreated, gingivitis can progress to periodontitis, a more severe form of gum disease that can lead to bone and tooth loss. Persistent gum inflammation despite proper oral hygiene may indicate underlying prediabetes or diabetes.

High blood sugar levels can compromise the immune system, making a person more susceptible to infections, including those in the mouth. Oral infections such as thrush (oral candidiasis) and oral yeast infections are more common in individuals with diabetes or prediabetes. Thrush, for example, is a fungal infection caused by an overgrowth of Candida albicans yeast in the mouth. C. albicans in healthy, non-immune compromised individuals does not typically cause any disease. Symptoms of oral thrush may include white patches on the tongue, inner cheeks, or roof of the mouth, along with soreness or discomfort. Recurrent or persistent oral infections may signal an underlying issue with blood sugar control.

Proper postoperative care is crucial, especially for individuals showing signs of prediabetes. This includes paying close attention to nutrition, with a focus on reducing sugar intake, increasing consumption of high-protein foods, and opting for smart carbohydrates. It is essential to reduce or eliminate processed foods because they can rapidly convert to glucose, potentially exacerbating prediabetes or tipping the balance into full diabetes. Maintaining strict oral hygiene is also paramount. Poor oral care can lead to infections and delayed healing, which is particularly problematic for individuals with hyperglycemia because they often experience impaired wound healing. Prioritizing oral health and adhering to these dietary recommendations can help prevent the progression of prediabetes and reduce the risk of developing diabetes-related complications.

In conclusion, the identification of potential signs of prediabetes through examination of the gums and teeth during routine dental screenings underscores the crucial role oral health care professionals play in early detection. The observed indicators-such as accelerated tooth decay, gum inflammation, and oral infections-serve as important signals for patients to seek further evaluation from their healthcare providers. Moreover, the implementation of postoperative care recommendations, emphasizing proper nutrition, strict oral hygiene, and avoiding processed foods, is essential in managing prediabetes and mitigating the risk of progression to more serious diabetic conditions. By adopting these measures, individuals can take proactive steps toward safeguarding their oral and overall health, ultimately reducing the burden of diabetes-related complications.

Jaclyn Tomsic, MD, DMD
Oral and Maxillofacial Surgeon
Cleveland, Ohio