Making Your Diabetes Patients Smile, Literally

Diabetes takes a toll on the entire body, but it can also increase a patient’s risk of dental disease. Gum disease can worsen when blood sugars are not under control and, in turn, gum disease can make diabetes harder to control.

A study in the Journal of the American Dental Association found that one in five cases of total tooth loss is linked to diabetes. 

Periodontal disease is the most common dental disease affecting those living with diabetes, impacting nearly 22% of this population. Other complications include salivary dysfunction, taste dysfunction, oral fungal and bacterial infections, oral mucosa lesions, delayed mucosal wound healing, and mucosal neuro-sensory disorders. (NCBI, NIH)

A study presented in the American Journal of Preventative Medicine in August 2014 titled, Impact of Periodontal Therapy on General Health, showed that treating patients with periodontal treatment resulted in an annual savings of $2,840 per patient. Inpatient hospital admissions also saw a 39.4% reduction for patients who received periodontal therapy. The significance of this correlation makes proactive dental care a priority for those interested in reducing cost of care.

Barriers to Dental Care

Financial Concern is a barrier for many. The American Association for Community Dental Programs’ 2015 Annual Symposium stated that over 108 million Americans lack dental insurance (2.5 times the number of those that have no health insurance).  So, approximately one-third of the American population is left to decide if they have the expendable income to go to the dentist. An adult cleaning can run anywhere from $75 to $250 per cleaning and cleanings are recommended twice a year. For a family of 4 the cleanings alone could run anywhere from $600 to $2,000 per year. That is equivalent to what it costs to feed a family of four for one to two months. If finances are tight, most people will choose feeding their family over preventative dental care. Even with dental insurance the cost can be prohibitive for many, causing people to only seek treatment if they are having pain. When patients are financially burdened, it can be helpful to provide them with a list of lower cost options in the area such as dental schools, dental hygiene schools, community health centers and free and low cost dental clinics.

Dental Anxiety is real and is often listed as the leading cause of inconsistent dental care. Even for those who go to the dentist regularly, most people still breathe a sigh of relief when the exam is over. For some, the anxiety crosses over into dental phobia which prevents them from crossing the threshold of any dental office. It can be helpful to remind patients that dental techniques have improved so much over the last few years and that modern dental treatment can now be completely painless.

Perceptions of Need means that what is a priority for one is not always a priority for another. Because of finances, anxiety and a lack of understanding of how to properly care for the teeth and mouth; many times the need to visit the dentist does not become a reality until a crisis erupts.

While many complications are part of managing diabetes, for the nearly 30 million people in the U.S. living with the condition, tooth loss and other dental health problems are least likely to be on their radar. Often gum disease is painless. Patients may only notice an issue when they already have some serious damage. As a result, dental issues may go untreated for years if a patient does not go for regular dental exams.

Like any other part of the body, teeth and gums need to be taken care of if we want them to continue to serve us throughout our lifespan. In the role as guardians of health, it is critical for dentists and physicians to work together to manage their patients with diabetes. Dental care can be a simple process, but many times it gets complicated by fear and cost. Reminding diabetes patients to control their blood sugar, brush, floss and visit their dentist regularly can go a long way toward improving patient health and reducing healthcare costs.

By Nancy Barton, RN, CDE
Fit4D Certified Diabetes Educator

Resources:
American Dental Association
American Diabetes Association
American Journal of Preventative Medicine
Alliance in Health Diabetes Control Center
Cost Helper Health
National Association of Dental Plans
Official USDA Food Plans: Cost of Food at Home
Oral Cancer Foundation