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Periodontal Disease and Diabetes

It has been shown that people who have diabetes are more prone to contracting infections than non-diabetic sufferers. It is not completely known but periodontal disease is often considered the 6th complication of diabetes; generally when the diabetes is not under strict control.

Periodontal disease (often called gum disease and periodontitis) is a prevalent condition that can lead to tooth loss if treatment is not rapidly sought. Periodontal disease starts with a bacterial infection in the gum tissue which envelopes the teeth. As the bacteria grow, the gum pockets become deeper, the gums recede as tissue levels are lowered and the periodontitis eventually destroys the boney area under the tissue.

Diabetes is characterized by an excess of sugar (glucose) in the blood. Type II diabetics are usually not able to control insulin levels which means excess glucose remains in the blood. Type I diabetics produce no insulin at all. Uncontrolled diabetes can lead to stroke and heart disease and is a serious condition.

Reasons for the Connection

Medical professionals suggest the relationship between periodontal disease and diabetes can make both conditions worse if either disease is not timely controlled.

Here are the links between periodontal disease and diabetes:

  • Increase in blood sugar – Severe and moderate periodontal disease raises sugar levels in the body, increasing the level of time the body has to regulate itself with high blood sugar. For this reason, diabetics with periodontitis have a harder time controlling their blood sugar. Also, the higher sugar levels found in the mouth of diabetics feed the very bacteria that makes periodontal infections worse.
  • Thickening of blood vessels – The thickening of the blood vessels is another major concern for sufferers of diabetes. The blood vessels generally serve a prime function for tissues by sending nutrients and eliminating waste products. With diabetes, the blood vessels become coagulated and these exchanges occur. This means that harmful by products are left in the mouth and can affect the resistance of gum tissue, which can lead to gum disease and infection.
  • Smoking – The use of tobacco does significant damage in the oral region. Not only does tobacco decrease the process of healing, it also vastly increases the possibility of an individual developing periodontal disease. For diabetics who smoke, the risk is substantially greater. In fact, diabetic smokers aged 40 and older are 20 times more likely to emerge with periodontal disease.
  • Poor oral hygiene – It is important for diabetics to continue maintaining excellent levels of oral health. When daily flossing and brushing does not happen, the dangerous oral bacteria may feed on extra sugar between the teeth and spread more easily under the gum line. This worsens the metabolic issues that the diabetics
  • continue to notice.

Diagnosis and Treatment

It is of vital importance for people suffering from all type of diabetes to visit the dentist at least 2 times a year for regular cleanings and check ups. Studies have demonstrated that routine non-surgical periodontal treatments can lower the HbA1c (hemoglobin molecule blood test) count by as much as 25% in a 6 month period.

Dr. Braithwaite will use the medical and family hiostory and dental radiographs to learn the risk factors for periodontal disease and decide on the precise condition of the teeth, gums, and underlying jawbone. If needed the dentist may work jointly with other specialists to ensure that both the gum disease and diabetes are controlled and managed as effectively as possible.

Non-surgical procedures administrered by the dentist and dental hygienist will include root planing, where the root of the tooth is polished and smoothed to remove any remaining bacteria, and deep scaling, where calculus (tartar) will be removed from the teeth above and below the gumline. Antibiotics may be placed in the gum pockets to promote excellent healing.

Before and after periodontal treatment, the dental team will recommend continued oral maintenance as well as proper home care. They may prescribe oral rinses which help stop the continued colonization of bacteria.

If you have concerns or questions about diabetes or periodontal disease, please consult with Dr. Braithwaite and his staff.