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Diabetes and oral health
- 1. DIABETES AND ORAL HEALTH NATIONAL DIABETES DAY NOVEMBER 14
- 2. DIABETES - TYPES ORAL CAVITY - PARTS
- 3. ORAL MANIFESTATIONS OF DIABETES DENTAL CARIES AND TOOTH LOSS FUNGAL INFECTIONS BACTERIAL INFECTION GEOGRAPHI C TONGUE FISSURED TONGUE ORAL MUCOSAL DISEASE PERIODONT AL DISEASES SALIVARY DYSFUNCTI ON DELAYED MUCOSAL WOUND HEALING
- 4. PERIODONTAL DISEASES • It is a chronic inflammatory disease affecting gingiva and periodontal tissues initiated by bacteria. MICROFLORA IN DENTAL PLAQUE ACCUMULATED DAILY GINGGIVAL INFLAMMATION DESTRUCTION OF PERIODONTIAL TISSUES AND ALVEOLAR BONE PERIODONTAL POCKET IS FILLED WITH BACTERIA AND TOINS DEEPER POCKET REACHING ALVEOLAR BONE TOOTH LOSS
- 5. Diabetes associated factors that increase Periodontal disease • Periodontal flora in diabetes patients composed mainly of – Capnocytophaga, Anaerobic Vibrios, and Actinomyces species • Increased glucose level in crevicular fluid • Defect in host response – Neutrophil impairement, decreased chemotais, phagocytosis and intracellular bacterial activity. • Vascular changes – basement membrane protein undergoes non-enzymatic glycosylation in hyperglycemic condition. • Decreased wound healing – decrease in collagen production due to glycosylation of collagen and other proteins.
- 6. SALIVARY AND TASTE DYSFUNCTION • Type I – reduced salivary flow rate and ×erostomia (dry mouth), especially those with neuropathy. • Type II – reduced salivary flow rate and erostomia with lower stimulated parotid gland flow rate in patients with poor control. • Polydypsia and polyuria. CONSTANT DRYNESS INFECTION INFLAMMATION DECAY IRRITATE THE ORAL MUCOSA UNCONTROLLED DIADETES SALIVARY DYSFUNCTION ELEVATION OF DETECTION THRESHOLDS (taste)
- 7. FUNGAL INFECTIONS • Oral candidosis is an opportunistic infection frequently cased by Candida albicans. • Predisposing factors along with diabetes – smoking, ×erostomia, old age, medications, Cushing’s syndrome, malignancies and the use of dentures. • Colonisation in diabetes patients – 75% and controls – 35.1%
- 8. BACTERIAL INFECTIONS • Impaired defense mechanism • Submandibular space infection was more common followed by buccal space infection. • Stay longer in hospital due to more severe infection and required more time to control their blood glucose. SUSCEPTIBLE *POOR CONTROL *DIABETIC COMPLICATIONS
- 9. DELAYED WOUND HEALING • Poor soft tissue regeneration and delayed osseous healing. (complication during oral surgery) • Delayed vascularisation, reduced blood flow, a decline in innate immunity, decreased growth factor production and psychological stress may be involved.
- 10. ORAL MUCOSAL DISEASE • Oral lichen planus (OLP) is a skin disorder that produce lesions in the mouth. More common in type I. Type I is also an autoimmune disease. Patients with diabetes prolonged state of chronic immune suppression. Acute hyperglycaemia alterations in immune response • Atrophic-erosive oral lesions – common in diabetes + OLP REASONS
- 11. DENTAL CARIES AND TOOTH LOSS • Cleansing and buffering capacity of the saliva is diminished in patients resulting in increased caries, especially in those with ×erostomia. • The relationship between diabetes and development of dental caries is still unclear.