Oral Health Problems and Diabetes (Nursing)

00:01 So first, I will start with something...

00:03 people don't normally think about with diabetes.

00:06 I'm going to start with, the mouth.

00:08 Going to take a look at that picture.

00:10 Now if I look in someone's mouth, you don't generally see things that big, we did that therefore impact, but the first step is understanding that you have glucose in your saliva.

00:21 Diabetic clinics have extra glucose in their saliva.

00:26 Now higher levels of glucose in their saliva causes bacteria to thrive.

00:31 So take a look at the picture, see the little squiggly, a little bugs that are in there.

00:36 We know that a diabetic client has higher levels of glucose.

00:40 So they've got some increased risk for some really healthy bacterial growth.

00:46 Now when you've got that bacterial growth, we're also going to have plaque and other issues.

00:51 So let's break it down very simply, just explain to them, hey, higher glucose can enter some extra bacterial growth in your mouth.

01:00 So I want to show you how you can help avoid that.

01:03 So bacteria plus the food that we eat you're going to end up with plaque.

01:09 Now you see the teeth of become kind of a little yellowed.

01:12 That's just to remind you that, that's what ends up putting that coating on your teeth, that can be really problematic.

01:18 See it's beyond how white your teeth look, plaque is a real sign of we got some trouble some things going on in the mouth that could lead to more complications.

01:28 So Mr. Sanchez, we know because you're diabetic, you're likely to have a little bit higher glucose in your saliva, then when you eat food, and the bacteria that's there.

01:38 You have an increased risk for developing more plaque than normal because the problem with plaque is Look at that picture of the mouth. See that...

01:47 Here, in here, in here, yeah, plaque increases the risk of gum disease.

01:55 Tooth decay, and inflammation.

01:58 Okay, that's really important.

02:00 You don't want to give this patient a laundry list, but you as a health care provider need to keep in mind, Hey, I know the saliva is got extra glucose, I know that's going to make bacteria thrive, Then when the patient eats, we're going to have more plaque around, and that plaque can be problematic that's going to be hard on their gums.

02:17 It's going to be hard on their teeth.

02:19 We want them to keep their own teeth as long as possible and it's going to exacerbate inflammation.

02:25 Now when inflammation gets out of control that causes all kinds of problems, so I want to give you a list of some common mouth problems with diabetes.

02:35 I'm just going to give you the names, so you recognize them.

02:39 But the cool part is I have some really fun pictures.

02:42 Now take a look at the mouth.

02:44 See this is called gingivitis.

02:46 It's an unhealthy or inflamed gums.

02:49 Now the gums right there above your teeth take a look at this patients gums.

02:53 See how red they are.

02:56 Now, when you go to a dentist, they can actually measure the depth of that inflammation and that's an indicator of gum health.

03:03 If your gums aren't healthy, we're going to have more problems with your teeth, and it's a sign of inflammation.

03:08 So when you think of gingivitis, look at that really red and gum that you see in the picture.

03:14 Now the next one's a bit of a mouthful.

03:16 Sorry to use that pun.

03:17 No, I'm not really sorry.

03:20 Periodontitis, that's just another overall phrase for gum disease.

03:25 Why do keep focusing on the gums? Remember when the gums are inflamed, that's a signal to us, that there's inflammation throughout the rest of the body.

03:35 When inflammation is out of control, we have really challenges things with like cardiovascular risk, strokes, heart attacks, It's just another measurement to let us know that inflammation is present and it could increase the risk for complications.

03:53 Okay, you might not have seen this yet and your practice, but when you do you will not forget it.

04:00 Some I'm just little babies get this but diabetic clients are at an increased risk for it.

04:04 Remember they've got that extra glucose in their saliva.

04:08 We call this thrush or candidiasis that is it's so painful.

04:15 It's so difficult for them, they don't want to swallow and it hurts all the time and they have these weird-looking spots.

04:22 So diabetic clients are an increased risk to develop this.

04:27 So we want them to know, hey, if you notice any changes in your gums, on your tongue or in your mouth, let us know.

04:33 Now we can treat this, they do what we call is a swish and swallow, right? You want to spit it out because it tastes horrible, but the medication that we use to treat this we use it topically.

04:45 Now this is...

04:49 Dry mouth. look at that tongue, isn't that awesome? You're right? It's like the Sahara but you know what I'm talking about, Xerostomia is dry mouth.

04:59 So Mr. Sanchez might not even be thinking about why his mouth is so dry.

05:05 This is a bit of a two-edged sword.

05:07 Now he can use some sugar-free gum, that'll help keep his mouth, there's also some drops that you can use for this but this really isn't comfortable when your mouth is dry.

05:18 Here's the warning sign.

05:19 I want you to be aware of as you're teaching him this though.

05:22 If he notices that he's really thirsty on top of a dry mouth.

05:27 Make sure he checks his blood sugar again because sometimes that's a signal that the blood sugar is high.

05:33 So dry mouth, have chew a little bit of gum, sip some water, these are things you can do to try to help combat that.

05:39 Now the last one, look at the color of this mouth.

05:45 Okay now, it's not just the gums, It's the whole mouth.

05:49 They've got this oral burning sensation.

05:52 It feels like their mouth is on fire.