A study cited by the American Diabetes Association notes that one in five people with severe gum disease may have type 2 diabetes and not know it. Interestingly, there are times when the dentist is the first to notice symptoms of diabetes and refer patients to a primary care physician for screening. If your child has been diagnosed with diabetes, managing your child's diabetes and keeping your child's mouth in good condition work to help each other. Those families that are impacted by the diagnosis of diabetes in one or more of their children need to be especially attentive to their child's oral health, and we can help keep your kiddo's mouth as healthy as possible.
Understanding Diabetes and Its Effect on the Mouth
Diabetes mellitus type 1 is a manageable disease that is sometimes called juvenile diabetes. In type 1 diabetes, there is no insulin production; therefore, there is nothing to break down carbohydrates eaten. Those with type 1 diabetes will need insulin therapy and a maintenance plan to control their lack of insulin.
Type 2 diabetes is the most common form of diabetes and can begin at any time. In this form of the disease, the body does not properly use insulin. It produces some, but not enough to counteract the increase in blood sugar. It may need treatment of diabetic diets, oral hypoglycemics, and possibly injectable insulin, depending on the severity of the disease (1).
Children with diabetes don’t have any more bacteria in their mouths than those who don't. The difference lies in how the body's inflammatory response to the bacteria is affected by diabetes. Children with diabetes have a higher risk of gum diseases, gingivitis (early gum disease), and periodontitis (the advanced stages of gum disease). This inflammatory response can lead to the loss of the tissues that support the teeth (2).
When your child eats sugary substances, the sugar level increases in their blood. This increase in their blood sugar causes their saliva to be high in sugar as well. Bacteria in the mouth eat this sugar and cause a sticky substance, plaque, to accumulate on their teeth. If the plaque is not removed, it can cause decay and gum disease.
High blood sugar can also weaken your child's immune system, the primary way your body fights infection. Therefore, you may see an increase in the time it takes for dental illness or disease to heal (3).
Most of the time, these symptoms are not related to diabetes, but they can sometimes be symptoms of diabetes (4).
● Dry mouth – Less saliva causes the mouth to feel dry. Many different medications can cause it. Fight dry mouth by encouraging your child to drink more water, and eat crunchy, healthy foods to help the flow of saliva, or even chew sugarless gum.
● Cavities – Saliva washes away debris from food and cuts down on the bacteria staying in the mouth. So, dry mouth may also lead to a higher risk of cavities.
● Gum inflammation and bleeding
● Taste – Food may begin to tastedifferent, but try not to add more sugar for flavor.
● Delayed wound healing
● Infections of the mouth
● Teeth eruption – Your child's teeth may come in faster than expected.
● Thrush
Let's talk a little about thrush. Thrush is a fungal infection of the mouth that comes from the yeast Candida. The symptoms may include:
● The inner cheeks, tongue, roof of the mouth, and throat may have white patches.
● There may be soreness or redness.
● Your child's mouth may feel as if it has cotton inside.
● They may complain of loss of taste.
● Your child may be in pain while eating or when swallowing.
● There may be cracking and redness at the corners of their mouth.
● The child may complain of a burning sensation in the mouth.
Thrush is uncommon in healthy people, but those with diabetes have a higher risk of getting this fungal infection because of their diagnosis. It can also multiply or spread more easily in those with diabetes or with weak immune systems, especially if they've taken antibiotics and have affected the natural flora in their digestive systems.
Healthcare providers can quickly diagnose thrush simply by looking in the mouth, or they may decide to do an esophagus endoscopy. A small sample may be removed from the mouth to be examined under a microscope. Thrush is usually treated with an antifungal medication applied to the mouth for 7-14 days (5).
For Teens and Adults: Those who smoke and have diabetes are up to 20 times more likely to develop thrush and periodontal disease. Because smoking impairs blood flow to the gums, this affects wound healing in mouth tissue (6).
Luckily, there are many things you can do to help keep your child’s mouth healthy. Maintain your child's blood sugar as close to normal as possible. Keep us informed of the status of your child’s diabetes, such as if your child has low blood sugar or hypoglycemia episodes. At each appointment, let us know the result of your child's last blood sugar reading (6).
Dental hygiene is essential. Brushing with a soft-bristled toothbrush at least twice daily (preferably after every meal) with fluoride toothpaste and flossing between the teeth at least once daily is so important. (Soft-bristle brushes are important as medium or hard bristles are more likely to cause tiny scrapes in the gums.) Cleaning any appliance your child has in his mouth that is removable each time they brush is also crucial. Plaque can build up on retainers or bridges, as it does on teeth, so keeping them free from debris is important, and children with braces should brush after each meal to ensure no food remains caught in their brackets, wires, or bands (6).
It is important to visit us twice a year for a checkup, cleaning, and to care for all your child's dental needs, whether your child has diabetes or not. Our dentists can keep on track and updated with any new findings from the child's primary care physician, any changes in their medications, and any lab work that may affect your child's treatment. If your child's blood sugar is uncontrolled, it will be necessary to postpone non-emergency dental procedures, since uncontrolled diabetes may impair healing or impact the time it takes to heal from those procedures. If a bracket or wire becomes dislodged, call our orthodontists as soon as possible so it can be repaired right away - to prevent any damage to soft tissues in the mouth, or extend the time needed to complete orthodontic treatment.
Conclusion
The oral health of those with diabetes may seem to be a complex cycle. Diabetes (uncontrolled) makes blood sugars higher, which impacts the saliva in the mouth. Higher levels of sugar in the saliva cause more for bacteria to eat, allowing more plaque to be produced and adhere to the teeth. This plaque can cause tooth decay, gingivitis, and periodontal disease if not removed with brushing, flossing, and rinsing. Tooth decay and gum diseases may lead to higher blood sugars due to infection. Uncontrolled blood sugars can impact a child with diabetes in many other ways, affecting other body parts.
This may be a complex cycle, but it can be stopped with good dental hygiene. As with children without diabetes mellitus, taking care of your child's teeth eliminates the bacteria that cause the teeth to decay and the gums to be diseased. Teaching your child the importance of brushing, flossing, and seeing the dentist for cleanings at least twice a year is the best initiative any parent can take to halt tooth decay and gum disease. Talk with our dentists at Jungle Roots Dentistry to plan your child's dental hygiene regimen today!
References
It’s time once again to get ready for fall, and that means deciding which snack and treat recipes to prepare. We scoured the internet for the best parent and kid-approved selections, compiling a list with plenty of variety. Whether your family celebrates Halloween or just enjoys the festivities of autumn, there are plenty of options for you. So, get your kiddos ready and take a peek at our favorite fall and Halloween recipes this year:
A cross between an art project and a snack-making session, this easy-to-assemble fall recipe is cute, entertaining, and wholesome. Create your Healthy Owl Crackers just like the instructions say, or substitute any nuts, dried fruits, crackers, or healthy spreads your family likes to make yours unique. Depending upon how many owls you want to make (it’s always nice to share), you can tailor this creative snack-creating time to your household’s schedule and make an afternoon of it – or just an hour!
This works for any meal or snack and makes an especially pretty dish if you’re having guests. The Autumn Leaf Fruit Salad with Edible Leaves can be set out in a bowl for before or after school, packed in zip locks to take to the park, or sent to school in an airtight container. Kids can help prepare the fruits while parents use leaf-shaped cookie cutters (yep, you’ll need some of those) to make the dazzling maple and oak leaf toppings. Best if kept refrigerated.
Pop these in lunchboxes, take them with you for after-school sports breaks, or set them out on the counter for tired kiddos to grab on their way out the door in the morning. Kid-friendly Pumpkin Energy Balls provide a quick pop of energy, are nut-free (appropriate for most schools), and are chock full of protein and vitamin A. One batch makes about 14 balls.
For a leisurely Saturday afternoon or a special Family Night treat, the Caramel Apple Fondue spread makes a creative and tasty project. Anyone who enjoys caramel apples will love this recipe – especially with all the fixings to make it extra awesome. (Just make sure everyone brushes their teeth or at least swishes with some water after this one – we don’t want to encourage cavities, and caramel is a sticky one!)
Can you think of a better use for pumpkin pie spice than a thick, nutrient-rich smoothie? We can’t either! Shugary Sweets makes a scrumptious Pumpkin Pie Smoothie for us with nothing but healthy ingredients to be served in the prettiest kid-friendly glasses you can find – or an insulated stay-cold thermos if you’re sending it to school. It’s meant to be served for breakfast, but we think it’s great for any time!
Your house is gonna smell good when you get this fragrant fall treat cooking in the crockpot! Once done and cooled, you can set Crock Pot Cinnamon Apple Chex Mix out for guests, take it along for afternoon snacking or give it away in cute fall tins as gifts. Kids love it in their lunches, too. This recipe is written for the gluten-free, vegetarian crowd, but we think everyone will enjoy it regardless of diet preferences! The Crock Pot Ladies also recommend swapping out dried fruit and/or nuts as you wish to make your own unique mix.
Impress friends and neighbors–or just your own kiddos–with this naturally delectable autumn treat. Healthy dark chocolate (choose one with the highest percentage of cocoa your kids will eat–hopefully at least 70%-for the antioxidants) and your leftover seeds from pumpkin carving (That’s right–don’t toss them out! They offer 12 grams of protein per cup!) blend together to make this inviting fall snack– Salted Dark Chocolate Pumpkin Seed Bark. This recipe makes a 9 x 13 pan of bark to break apart as you wish.
Just in case you don’t think apple cider is delicious enough as is, brilliant minds take things up a notch with these amazing Apple Cider Slushies. Served with appetizers, snacks, or warm donuts, these icy treats make a definite impression on guests and family alike. Use the blog’s creator’s idea of hollowed-out apple cups for serving, or dig out your fancy holiday glassware for this delightful beverage.
Your kids might think they don’t like squash–but they haven’t tried THESE yet! Calling for a super easy few minutes of prep followed by 30 minutes in the oven, the SuperHealthyKids site brings an exquisite dish to your autumn table. When sliced into their natural shape of flowers, Sweet Roasted Acorn Squash Flowers are superb for a side dish or a hot and nutritious appetizer. However you choose to serve these, make sure the kids help make them–they’ll usually grow more fond of squash if they make it themselves.
Apple Nachos take healthy fresh apples sliced thin for the bottom layer and top them with nutritious coconut, dark chocolate chips, and melted almond butter. This is the perfect dessert after a healthy autumn meal, especially if you use the apples you picked yourself on your trip to the orchard. (And if you happen to have leftover toppings from Caramel Apple Fondue night, you can use them up with this nifty concoction–sans the caramel, so it’s healthier– and folks will be none the wiser!)
What’s Halloween without candy corn? Not much, we think! This fruity treat with a twist on the tri-colored candy is a hit with kids and health-conscious parents alike! Not only is it colorful and fun to make, but it also brings a dash of potassium, bromelain, and vitamins A and C (among many others!) to your table. Set these out as the perfect autumn afterschool snack, Halloween goodies, or even a dessert. You can always let the kiddos help you make it–even toddlers can help with this one! Get the recipe from Feasting on Fruit blog.
Kids love to get silly, and they’ll be in good company when you make these adorable Silly Apple Bites. Easy to prep and put together, every bite is nutritious, and the cute smiling apple faces are ideal for any non-scary Halloween festivities. The really cool part? Even the googly eyes are homemade–and vegan to boot!
These adorable critters make a yummy appetizer, creative Halloween treat, or a weekend meal at home. Packed with protein (meat and cheese) and vitamin A (sweet potato fries for the legs), they’re also highly nutritious. This Taste of Home recipe makes enough for 12 servings–so double it if it’s for a party.
Not into meat, or just prefer a cold sandwich instead? Give these PB&J Spider Sammies a whirl!
Keep snack time simple with these adorable clementine pumpkins this fall, an easy-peasy Halloween snack that kids, even toddlers, can help you make. With their lovely fall color, clementines are usually in stores just in time for October 31st! (If not, you can make them with tangerines, just make sure you serve them fresh.) They also tend to be an allergy-safe choice for sensitive kiddos. Put them out on the table after school or serve them at a Halloween shindig–they work almost anywhere!
The creators at Strength and Sunshine kicked super-sugary marshmallows to the curb for this iconic recipe and replaced it with everyone’s favorite fall flavor – you guessed it, pumpkin spice! These Pumpkin Spice Rice Krispie Treats are healthy, vegan, allergy-free, and gluten-free to boot! Using pure pumpkin puree, brown rice syrup, and other natural ingredients, you’ll feel good about serving this dessert/snack to your kids and their friends this fall/Halloween. (To make it more “Halloween-ish,” sprinkle the top with orange and black mini-M&Ms; they’re usually in stores seasonally.)
These flavorsome cheesy witches’ broomsticks can be made with chunks of almost any cheese, but the mozzarella cheese sticks pictured above get the best results. Put them out for an appetizer, or bring them to a get-together in any kid-friendly setting! Cute and healthy, your kids will love to munch these anytime.
Another simple choice, these mini Halloween quesadillas make an outstanding kids’ meal (especially if you’ve got the sides to go with it, i.e. avocado slices, sour cream, mild or homemade salsa, etc). Just have your littles choose their cheese slices, get out your tortillas, and follow the easy directions on the site! You can just use black olive slices and a dab of sour cream if you don’t want candy googly eyes. They taste better with quesadillas anyway!
These savory mummy meatballs are nourishing enough for a meal or the snack table at your Halloween gathering. Served warm and made with your choice of meatballs (ground beef, turkey, or even vegan) and quick-baking strips of crescent rolls, they can be dipped in marinara and freshly grated parmesan and eaten with forks – or just pop them into hungry mouths!
Slightly reminiscent of our mini-quesadillas, this recipe is for families who love a warm, gooey grilled cheese on a crisp fall day. (And what family doesn’t?) You’ll be dipping your Grilled Cheese Ghosts in your cup of soup (or homemade ketchup) —or toss a slice of ham on it —for some healthy Halloween munching in no time!
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