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[IP] diabetes and dentist

I'm a dentist who has cared for hundreds of diabetic patients and can think 
of no reason  why a diabetic would have weaker teeth.  Unfortunately, there 
are over  400 medications which can cause a dry mouth, and having less saliva 
than normal definately causes more tooth decay.  Diabetics on a medication to 
treat one of the many possilbe complications could well have a dry mouth.  
The best treatment is to switch to a different medication when possible, but 
this is often not a possibiliity.    A prescription fluoride toothpaste like 
Prevident is very helpful.  Watching out for the frequency of carbohydrates 
in the diet is important (I know this is often also not possible-I am also 
the mother of an adolescent diabetic, thank heavens on a pump) but people 
with a dry mouth frequently tend to sip things with a small amt. of carb or 
eat mints etc. often, as a comfort measure, and this really causes decay 
problems.  Saliva substitutes (my favorite is Oral Balance gel-usually not on 
the shelf but most drug stores can get it in within 24 hours and it's non 
prescription) can make it easier to avoid sipping.  It's not the amount of 
the carbohydrate in controlling cavities, it's decreasing the freqency.  I am 
also a very strong believer in fluoridated water-probablly a lot more 
important than in-office fluoride treatment every 6 months.
Diabetics do have a strong tendency to periodontal (gum) disease.  Poorly 
controlled perio disease makes it very difficult to control diabetes, and 
poorly contolled diabetes makes it impossible to treat periodontal disease 
effectively.  Regular  well done professional cleanings are important.  
Flossing is important but I think once a day is great-diabetes is hard enough 
without trying to floss several times a day (in general-could be different 
when perio disease is a major problem)
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