It is well documented that people who suffer from diabetes are more susceptible to developing infections than non-diabetes sufferers. It is not widely known that t periodontal disease is often considered the sixth complication of diabetes; particularly when the diabetes is not under proper control.
Periodontal disease (often called periodontitis and gum
disease) is a progressive condition that often leads to tooth loss if treatment
is not promptly sought. Periodontal disease begins with a bacterial
infection in the gingival tissue which surrounds the teeth. As the
bacteria colonize, the gum pockets become deeper, the gums recede as tissue is
destroyed and the periodontitis eventually attacks the underlying bone tissue.
Diabetes is characterized by too much glucose (or sugar) in
the blood. Type II diabetics are unable to regulate insulin levels which
means excess glucose stays in the blood. Type I diabetics do not produce
any insulin at all. Diabetes is a serious condition that can lead to
heart disease and stroke.
Reasons for the Connection
Experts suggest the relationship between diabetes and
periodontal disease can worsen both conditions if either condition is not
properly controlled.
Here are ways in which diabetes and periodontal disease are
linked:
• Increased
blood sugar – Moderate and
severe periodontal disease elevates sugar levels in the body, increasing the
amount of time the body has to function with high blood sugar. This is
why diabetics with periodontitis have difficulty keeping control of their blood
sugar. In addition, the higher sugar levels found in the mouth of
diabetics provide food for the very bacteria that worsen periodontal
infections.
•
Blood
vessel thickening –
The thickening of the blood vessels is one of the other major concerns for
diabetes sufferers. The blood vessels normally serve a vital function for
tissues by delivering nutrients and removing waste products. With
diabetes, the blood vessels become too thick for these exchanges to occur.
This means that harmful waste is left in the mouth and can weaken the
resistance of gum tissue, which can lead to infection and gum disease.
•
Smoking – Tobacco use does a great deal of
damage in the oral region. Not only does tobacco use slow the healing
process, it also vastly increases the chances of an individual developing
periodontal disease. For diabetics who smoke, the risk is exponentially
greater. In fact, diabetic smokers aged 45 and over are twenty times more
likely to develop periodontal disease.
•
Poor oral hygiene – It is essential for diabetics to maintain excellent
levels of oral health. When daily brushing and flossing does not occur,
the harmful oral bacteria can ingest the excess sugar between the teeth and
colonize more freely below the gum line. This exacerbates the metabolic
problems that diabetes sufferers experience.
Diagnosis and Treatment
It is of paramount importance for people suffering from any
type of diabetes to see the dentist at least twice yearly for checkups and professional
cleanings. Studies have shown that simple non-surgical periodontal
treatments can lower the HbA1c (hemoglobin molecule blood test) count by as
much as 20% in a six-month period.
The dentist will use medical history, family history, and
dental X-rays to assess the risk factors for periodontal disease and determine
the exact condition of the gums, teeth, and underlying jawbone. If
necessary the dentist will work in conjunction with other doctors to ensure
that both diabetes and gum disease are being managed and controlled as
effectively as possible.
Non-surgical procedures performed by the dentist and dental
hygienist include deep scaling, where calculus (tartar) will be removed from
the teeth above and below the gum line, and root planing, where the root of the
tooth is smoothed down to eliminate any remaining bacteria. Antibiotics
may be applied to the gum pockets to promote healing.
Before and after periodontal treatment, the dentist and
hygienist will recommend proper home care and oral maintenance as well as
prescribing prescription mouthwashes which serve to deter further bacteria
colonization.
If you have questions or concerns about diabetes or
periodontal disease, please ask your dentist.
