CHANGES THE MOUTH AND THROAT - COMPLICATIONS OF DIABETES.
1. Apht1we. Little whitish patches are often seen on the gums of diabetic patients; they are slightly resistant when brushed away, and after their removal the spot where they were appears a little hyper emic. These are colonies of oidium albicans, which finds a favorable soil in the loose epithelium sodden with a saccharine solution. The weakly acid reaction of the buccal fluids, which is the rule almost without exception in cases of diabetes, may also favor the growth of the fungus. Cases have occasionally been observed in which the aplithous organism has penetrated into the vessels of the mucous membrane and thence has been carried to the lungs and brain, giving rise to embolism in these organs. Aphthous stomatitis, like the fungous growth on the genitalia, belongs to the complications of dia betes which may be prevented by cleanliness.
2. Gams and Teeth.—Affections of these parts are exceedingly common, and very few diabetics escape them entirely. Gingivitis is frequent, as is also alveolar periostitis; the teeth become loose and readily fall out. This trouble often appears early, causing consider able annoyance, and not infrequently suggests to the dentist the ad visability of examining the urine for sugar, so leading to the diag nosis of diabetes.
In other cases caries of the teeth is a more prominent symptom than the inflammation of the surrounding parts.
Evidently the cause of these troubles of the teeth and gums is to be referred to the lowered power of resistance of the tissues to attack by the schizomycetes, which are always so abundantly present in the mouth and take advantage of every injury of the gum and of every loosening of the dental periosteum to invade the parts. The simple loosening and dropping out of the teeth appears, on the other hand, to be due to the action of trophoneurotic causes.
The inflammatory and carious processes may doubtless be in great part, if not wholly, avoided by careful cleansing of the mouth. The use of too stiff tooth brushes is inadvisable, as they are likely to produce slight wounds of the gums. The teeth should be brushed and the mouth rinsed out several times a day; the most suitable mouth-wash is a three-per-cent. solution of borax.
3. Chemistry of the page 98.