Make the Most of Your Mouth

Diabetes and Dental Care: Ask the Dentist

Dentist Steven E. Roth, DMD, answers your additional questions about diabetes and dental care.

Question:

I brush with Crest and rinse with Listerine on a regular basis. I visit the dentist every six months. Two weeks ago, I visited my dentist for a sore gum adjacent to a top molar. An X-ray, along with tapping the tooth, indicated that the molar seemed healthy. The X-ray indicated that my sinus cavity was congested. I have diabetes and high blood pressure, so I’m reluctant to take sinus capsules. The pain is only on one side of the molar. Rinsing with hydrogen peroxide or Listerine is not helping. Does this indicate that the molar might be bad, or could it be something else?

Answer:

The best answer is that the examining clinician knows best. A sore gum and a sinus issue are usually unrelated. Diabetics have a very high incidence of gum inflammation due to the disease. It sounds to me like you are a very conscientious dental patient. I would have a sinus issue ruled out by a physician and then have the gum examined again by your dentist.

Question:

What is the cause of halitosis, and what can be used to cure it?

Answer:

Halitosis, or “bad breath” has a number of causes. Food odors, gum disease, tooth decay, stomach problems, sinus problems, and even certain diseases can all cause halitosis. The cures vary. To knock out any possible dental causes, I always advise my patients to have a good cleaning and examination, followed by a review of your at-home oral hygiene regimen. Your dentist can help you figure out the exact cause and treatment. Most mouth rinses can help, but the results will be temporary.

Question:

I am on a lot of medicine for chronic pain. I have been on morphine and oxycodone for 8 years, plus high blood pressure meds and diabetic meds. Overall, I take 16 different prescription medications. Now all of my upper teeth near the gums are decaying, how do I stop this from getting worse? Also, the last time I went to the dentist, it cost me a little over $1,200.00. Is there a school that I could go to that would help me cut the costs?

Answer:

The medications you are taking, in addition to having high blood pressure and diabetes, are all likely contributors to the poor state of your teeth. You need to see a dentist, whether by private care, public assistance, hospital-based dentistry, or at a dental school. There are some preventive measures that can be taken, but the decay needs to be treated ASAP. Please call your local dental society for a referral to an affordable dentist or dental program.

Question:

I have gum disease and diabetes, and I have lost several teeth. I want to know how to prevent this from getting worse, to keep from losing more teeth. What can the dentist do to help me?

Answer:

The diabetes and gum disease are both contributors to the poor state of your teeth. You need to see a dentist, whether by private care, public assistance, hospital-based dentistry, or at a dental school. There are some preventive measures that can be taken, but the decay needs to be treated ASAP. Please call your local dental society for a referral to an affordable dentist or dental program.

Question:

I have type 2 diabetes. I had to have a tooth pulled last month, and recently I discovered that another tooth is now loose. Should I have that one pulled, as well? It is not hurting. I was kind of hoping it would tighten back.

Answer:

Teeth do not tighten back on their own. If you have a loose tooth, it is a sign that you need a full mouth comprehensive examination, followed by a specific diagnosis. Waiting will only allow the disease to worsen.

Question:

What would cause your breath to taste like ammonia?

Answer:

Some breath odors are related to dental issues, and some are not. In your case, I would recommend a visit to your physician for a checkup. “Ammonia breath” can be as innocuous as low blood sugar, or as serious as a kidney problem.

Question:

How do diabetics care for their dental health?

Answer:

Diabetics should see their dentists regularly. The most common oral health problems associated with diabetes are tooth decay, periodontal (gum) disease, salivary gland dysfunction, fungal infections, lichen planus and lichenoid reactions (inflammatory skin disease), infection and delayed healing, and taste impairment. Diabetics should carefully review their medical history with their dentists and have a comprehensive dental examination. Great preventive home care and regular scaling are essential for the diabetic.

Question:

I have not been to the dentist in some time, and I have a missing filling and a broken tooth. What can I do to take care of my teeth myself, as I cannot afford to go to the dentist at this time? What are some things I can do at home? I am a diabetic.

Answer:

I would call the local dental society in your area for a referral to an affordable dental care facility or public assisted dental care. Great preventive home care and regular scaling are essential for the diabetic. However, treating yourself at home is never a good idea. I would recommend getting to a dentist ASAP.

Question:

I am a diabetic. For months now I have had a white cottage cheesy slime on my tongue. I brush several times a day but it keeps coming back. How can I treat this symptom?

Answer:

Diabetics are susceptible to fungal infections and other inflammatory skin and tissue diseases. I would strongly recommend a visit to your dentist. This is a condition that requires immediate attention!

Question:

When are dental implants not suitable for diabetics?

Answer:

The well-controlled diabetic, with stable blood sugar and no gum inflammation is the best candidate for dental implants. Your implant specialist will take a detailed medical history and perform a comprehensive pre-surgical exam before recommending dental implants.

Question:

I have type 2 diabetes and I haven't been to a dentist in many years. My mouth is not in the best of shape, but I'm scared of the dentist. Do you have any suggestions?

Answer:

There are many dentists who have special skills in dealing with phobic patients. But in many cases, it is just a matter of finding someone you can trust. What I can tell you is that there is nothing to be gained and plenty to be lost by waiting. Whatever dental problems you have will get worse. So call your local dental society to find someone that can help you with your anxiety and your dental problems.

Question:

What does a black, fuzzy tongue mean?

Answer:

There is a condition called Black Hairy Tongue that is caused by an overgrowth of bacteria. It can also be caused by medications, such as Pepto-Bismol, or several oral medications. The best answer is to see your local dentist for an examination and treatment.

Thank you for joining us for WebMD Ask the Dentist. Be sure to check in on Aug. 12 at 1 p.m. ET when we’ll cover children’s dental care. When should children start visiting the dentist? Sign up if you’d like an email reminder the day before the event.