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Diabetes and Periodontal Disease

It's important for your dentist to know if you have diabetes, and how you're controlling it. Good control of your diabetes affects your oral health as well as your overall health.

Diabetics tend to be less resistant to infection than non-diabetics, have more fragile bones, and take longer to heal after an operation.

An oral infection can make diabetes worse, which makes the infection worse, which makes the diabetes worse - and so on into a major medical problem.

Diabetics develop severe gum disease more often, too, especially over the age of 40. Once gum inflammation - gingivitis - sets in, it can erupt into periodontal disease or even infection in the jaw. In undiagnosed or uncontrolled diabetics, this could mean tooth loss.

How to hang on to your teeth?

Practice preventive dentistry and follow the medication, diet, and meal schedules recommended by your physician. This, with balanced rest and exercise, will bolster your resistance to disease, including oral infections and cavities.

If you're taking insulin injections, you may want to schedule appointments around your medication times. The stress of an examination or procedure can change the way your body uses insulin. Your dentist will want to be prepared to help you in case you have a reaction. And let him or her know if you are taking any other medications. Drug interactions can be serious.

You may want to have your gums examined (and have a dental cleaning) by a dental hygienist more often than twice a year - just to make sure nothing suspicious gets started.

And on the home front, good dental hygiene - controlling plaque, the invisible bacterial film that undermines teeth - is crucial. Home care rules to live by: brush at least twice a day and floss at least once a day. The more, the better.

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Oral Hygiene, Periodontal Disease And Heart Disease

The well-known risks for heart disease include smoking, obesity, high cholesterol, and high blood pressure. Now evidence suggests that having gum disease puts you at greater risk for cardiovascular (heart) disease.

The bacterial infection that causes periodontal disease also may affect the heart. In fact, all other conditions being equal, people with periodontal disease may have twice the risk of having a fatal heart attack as people that don't have periodontal disease. By taking care of your periodontal health, you can prevent or help control one of the risk factors for heart disease.

Although the exact mechanism of infection has not been determined, it is possible that the bacteria that cause periodontal disease enter the blood stream directly through the gum tissue. This can be precipitated by normal oral activities, such as brushing and chewing, that create tiny injuries in the gum and then release bacteria into the blood stream.

The bacteria can contribute to small blood clots that clog the arteries. There also is the possibility that the inflammation caused by periodontal disease contributes to the build-up of fatty deposits inside the heart arteries and the formation of blood clots. These clots can obstruct the normal blood flow, restricting the amount of nutrients and oxygen to the heart and resulting in a heart attack.

Oral bacteria can also travel to the heart and cause an infection of the lining or valves of the heart called infective endocarditis. People with a history of rheumatic heart disease, mitral valve prolapse with regurgitation, or heart murmur associated with various heart conditions are at greater risk of developing infective endocarditis and may require antibiotic treatment before dental procedures that may induce bleeding.

These procedures include oral surgery, tooth extraction, and routine cleanings. The best way to avoid infective endocarditis is by maintaining good oral health. But if you have any of the conditions that put you at greater risk for infective endocarditis, consult your cardiologist and dentist before starting any dental treatment.

Treatment of periodontal disease may be one of the ways you can help prevent heart disease and a heart attack. With meticulous oral hygiene, daily brushing and flossing, professional cleanings, and periodontal screenings, you may help save your teeth and your life.

By Laura Minsk, DMD