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 periodontal disease is often considered the sixth complication of diabetes, particularly when the subject's diabetes is not under proper control.
Periodontal disease (often called periodontitis or 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 that 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 that 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 that 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 levels of periodontal disease elevate 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 a major concern for diabetes sufferers. The blood vessels normally serve a vital function for tissues by delivering nutrients and removing waste products. With diabetes, blood vessels become too thick for these exchanges to occur. This means that harmful waste is left in the mouth, weakening the resistance of gum tissue and leading 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 20 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 do not occur, 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 their 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 percent in a six month period.
Your dentist will use your medical history, family history, and dental X-rays to assess the risk factors for periodontal disease and determine the exact condition of your gums, teeth, and underlying jawbone. If necessary, your dentist will work in conjunction with other doctors to ensure that both diabetes and gum disease are being effectively managed and controlled.
Non-surgical procedures performed by your dentist or dental hygienist include deep scaling, during which calculus (tartar) will be removed from the teeth above and below the gumline, and root planing, during which 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 prescribe prescription mouthwashes that serve to deter further bacteria colonization.
If you have questions or concerns about diabetes or periodontal disease, please contact our office.