Diabetes and Oral Health: There is growing scientific evidence that suggests a strong relationship between your oral health and your overall health. Striving to achieve optimal health is essential for everyone and this becomes even more important when your general health has been affected in some way. The Ontario Dental Association is pleased to provide this overview of important information that focuses on the relationship between diabetes and oral health care. My name is xxx and I am a member of XXX Component Society of the Ontario Dental Association (ODA). The ODA and its member dentists are committed to providing exemplary oral health care to the people of Ontario. Every April, the ODA rolls out Oral Health Month to help build awareness about the importance of oral health for all ages. This year, our subject continues along the theme concerning the relationship between oral and overall health, with particularly focus on diabetes.

Diabetes and Oral Health Approximately 2.25 million Canadians have diabetes Nearly 1 million people with diabetes live in Ontario By monitoring any oral infections that affect your gums and jaw, your dentist may help detect signs of early onset diabetes It is estimated that 2.25 million Canadians have diabetes. Many are unaware they have the condition. In Ontario, there are more than 706,500, or 7.5 per cent of the population living with diabetes. Research shows that gum disease and diabetes can affect one another. For instance, gum disease can intensify the complications associated with diabetes by increasing blood sugar. Blood sugar levels that remain high over a period of time are associated with premature degeneration of your eyes, kidneys, nerves, and blood vessels. By monitoring any oral infections that affect your gums and jaw, your dentist may help detect signs of early onset diabetes. To get us started, I/we would like to provide you with an overview of the presentation you will be seeing today.

Diabetes and Oral Health Overview What is diabetes? How does diabetes affect my oral health? What are some of the risk factors/symptoms? Taking control Proper oral hygiene Questions? Today, I/we will be highlighting to you exactly what diabetes is and how it can affect your oral health – as well as the effect of your oral health on your diabetes if you already have the disease. I/we will briefly outline some of the more common risk factors and symptoms, and address steps that you can take to reduce your risk of getting diabetes. I/we will conclude with questions and answers, but if there is anything you would like clarified throughout the course of the presentation, please don’t hesitate to ask.

Diabetes and Oral Health What is diabetes? Diabetes is a condition in which the body does not produce or properly use insulin – a hormone needed to absorb sugar (the basic fuel for cells). As a result, the body cannot use sugars from food. What is diabetes? Diabetes is a condition in which the body does not produce or properly use insulin – a hormone needed to absorb sugar (the basic fuel for cells). As a result, the body cannot use sugars from food.

Diabetes and Oral Health Facts about diabetes* More than 2 million Canadians suffer from diabetes The number is expected to grow to 3 million in the next 4 years Among people with diabetes 80% will die of stroke or heart disease 1,000 + Ontarians every week learn that they have diabetes Ontarians with diabetes make up 7.5% of the population, but account for: 32% of heart attacks 30% of strokes 51% of new dialysis cases 70% of limb amputations# Here are some fascinating facts about diabetes More than 2 million Canadians suffer from diabetes This number is expected to grow to 3 million in the next 4 years Among those people with diabetes, 80% will die of stroke or heart disease More than 1,000 Ontarians learn that they have diabetes every week Although Ontarians with diabetes make up 7.5% of the total population, they account for: 32% of heart attacks 30% of strokes 51% of new dialysis cases 70% of limb amputations These statistics help to underscore the seriousness of diabetes and why it has become so prevalent within media reports and, of course, within the medical community. *Canadian Diabetes Association – Snapshot on Diabetes: The Ontario Report # ICES Practice Atlas: Diabetes in Ontario, June 2003

Diabetes and Oral Health In type 1 diabetes the body makes little or no insulin This often leads to total insulin deficiency This condition tends to occur in individuals under 30 years of age, most often in childhood or during the teen years; older patients exhibit this form of diabetes on occasion In type 1 diabetes the body makes little or no insulin This often leads to total insulin deficiency This condition tends to occur in individuals under 30 years of age, most often in childhood or during the teen years; older patients exhibit this form of diabetes on occasion What’s happening in the body? The stomach changes food into glucose/sugar The glucose enters the bloodstream through blood vessels The pancreas, responsible for insulin production, produces little or no insulin in a person with type 1 diabetes Therefore, little or no insulin can enter the bloodstream As a result, glucose builds up in the bloodstream. This is known as hyperglycemia © 2005 WebMD Inc. All rights reserved. http://www.ghi.com/yourhealth/encyclopedia/articles/diabetes_basics.html

Diabetes and Oral Health In type 2 diabetes the cells in the body do not respond properly to insulin produced patients still produce insulin, but the body doesn’t respond properly to the hormone. Direct relationship between the degree of obesity and the risk of developing type 2 diabetes in both children and adults In type 2 diabetes the cells in the body do not respond properly to insulin produced patients still produce insulin, but the body doesn’t respond properly to the hormone. Direct relationship between the degree of obesity and the risk of developing type 2 diabetes in both children and adults What’s happening in the body? The stomach changes food into glucose/sugar Glucose enters the bloodstream through blood vessels The pancreas, responsible for insulin production, makes insulin Insulin enters the bloodstream In type 2 diabetes, glucose cannot be absorbed by the cells of the body, As a result there is a build-up of glucose in the blood vessels instead of being used by the body for energy. © 2005 WebMD Inc. All rights reserved. http://www.ghi.com/yourhealth/encyclopedia/articles/diabetes_basics.html

Diabetes and Oral Health Risk Factors 40 or older? You may be at risk of type 2 diabetes Testing every three years is recommended Other risk factors that may require more frequent testing: Member of a high-risk group Overweight Family member with diabetes Had/have gestational diabetes High blood pressure High cholesterol What are the risk factors for diabetes? If you are aged 40 or older, you are at risk for type 2 diabetes and should be tested at least every three years. If any of the following risks factors apply, you should be tested earlier and/or more often. Other risk factors that may require more frequent testing include: Being a member of a high-risk group (Aboriginal, Asian, South Asian or African descent) Overweight (especially if you carry most of your weight around your middle) Having a family member with diabetes Health complications that are associated with diabetes Given birth to a baby that weighed more than 4 kg (9 lb) Have or had gestational diabetes Impaired glucose tolerance or impaired fasting glucose High blood pressure High cholesterol

Diabetes and Oral Health Symptoms Unusual thirst Frequent urination Weight change (gain or loss) Extreme fatigue/lack of energy Blurred vision Frequent or recurring infections Cuts and bruises that are slow to heal Tingling or numbness in the hands or feet Trouble getting or maintaining an erection NOTE: Many people with type 2 diabetes display no symptoms What are the symptoms? Signs and symptoms of diabetes include the following: Unusual thirst Frequent urination Weight change (gain or loss) Extreme fatigue or lack of energy Blurred vision Frequent or recurring infections Cuts and bruises that are slow to heal Tingling or numbness in the hands or feet Trouble getting or maintaining an erection It is important to recognize, however, that many people who have type 2 diabetes may display no symptoms at all.

Diabetes and Oral Health Left untreated, diabetes can result in a variety of complications, such as: Heart disease Kidney disease Eye disease Problems with erection (impotence) Nerve damage Infections and other serious complications People with diabetes also face a greater risk of developing oral infections and gum disease If left untreated, diabetes can result in a variety of complications, such as heart disease, kidney disease, eye disease, problems with erection (impotence), nerve damage, resulting in extremities (hands and feet) losing sensation. As a result, people with diabetes are often unaware of injuries. A person with reduced sensation is less likely to notice small cuts or blisters if and when they occur. This can lead to infections and other serious complications. Studies have shown that people with diabetes also face a greater risk of developing oral infections and periodontal (gum) disease than those who do not have diabetes.

Diabetes and Oral Health Oral health problems associated with diabetes: Tooth decay Gum disease Dry mouth Fungal infections Lesions in the mouth Taste impairment Infection Delayed healing The most common oral health problems associated with diabetes are: tooth decay; gum disease; dry mouth; fungal infections; lesions in the mouth; taste impairment; infection and delayed healing.

Diabetes and Oral Health There is some good news! The good news is that treatment of either disease can lead to improvements in the other. Focus on: Healthy eating Watching your weight Physical activity Taking control The good news is that the treatment of either gum disease or diabetes can lead to improvements in the other. Scientists believe that lifestyle changes can help prevent or delay the onset of type 2 diabetes. Eating right, watching your weight, physical activity and being proactive – or taking control of your health – can certainly help.

Diabetes and Oral Health Take control: Stay in touch with your dentist and other health providers Let your dentist know: If you have been diagnosed with diabetes If the disease is under control If you take insulin, and when your last dose was administered If there has been any other change in your medical history, and The names of all prescription and over-the-counter drugs Staying in touch with your dentist and other health providers to assist you in the treatment of your diabetes is important. Communication with your dentist is vital. Let your dentist know: If you have been diagnosed with diabetes If the disease is under control If you take insulin, and when your last usual dose of insulin was administered If there has been any other change in your medical history, and The names of all prescription and over-the-counter drugs (even ‘natural’ medicines) you are taking

Diabetes and Oral Health Your oral hygiene routine should include: Brushing 2-3 times a day (whether real or replacement teeth) Flossing once daily Using toothpaste containing fluoride Limiting sweets; and Visiting your dentist regularly. To help protect your teeth and gums against oral disease and maintain overall good health, your oral hygiene routine should consistently include: Brushing your teeth 2-3 times a day (whether they are real or replacement) and flossing once daily; using toothpaste containing fluoride; limiting sweets; and visiting your dentist regularly.

Diabetes and Oral Health Summary Your oral health and overall health are related, so talk to your dentist Research shows that gum disease and diabetes can affect each other Good oral hygiene and regular dental exams are important steps in preserving good health Your oral health and overall health are related, so it’s important to talk to your dentist. By monitoring any oral infections that affect your gums and jaw, your dentist may help detect signs of early onset diabetes. Research shows that gum disease and diabetes can affect each other. For instance, gum disease can increase the severity of complications of diabetes by increasing blood sugars. The good news is that the treatment of either disease can lead to improvements in the other. Good oral hygiene and regular exams by your dentist that include an examination of the entire mouth are important steps in preserving good health.

Diabetes and Oral Health ? THANK YOU. Any questions? The information which we have shared with you today has been provided to help you better understand the relationship between your oral health and your overall health. I/we thank you for your attention and encourage everyone to practice proper oral hygiene techniques that include regular visits to your dentist. On behalf of the XXX Component Society of the Ontario Dental Association, it has been my/our pleasure to provide you with this overview of important information relevant to diabetes and oral health. If you have any questions, I/we will be happy to field them.

Diabetes and Oral Health: