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Gum Disease and Diabetes

Periodontitis and diabetes are both chronic diseases that modulate each other. That is, they can exacerbate each other, each making the other more severe. Diabetes can have a negative effect on periodontal health and periodontal disease can increase the need for insulin in diabetics.

Periodontal Disease Has a Negative Effect on Diabetic Control

Periodontal disease is an infection that, like any infection, can make it hard to keep blood sugar under control. Increased blood sugar levels can result in an increased risk for diabetic complications such as harm to the eyes, nerves, kidneys, and other important organs. But studies have shown that treatment of periodontal disease can reduce the need for insulin in diabetics. So, by treating and controlling the periodontal infection, a person also is controlling insulin need and diabetes.

Poor Diabetic Control Has a Negative Effect on Periodontal Health

Compared to non-diabetics, people with poorly-controlled diabetes (those with blood glucose levels above normal) are more likely to develop periodontal abscesses and other oral infections. The longer someone has diabetes, the more likely they are to have periodontal disease. And if the person smokes and has poorly-controlled diabetes, the risk of developing periodontal disease is even greater.

Poor diabetic control can affect the gum tissue in two ways. One is the result of the thickening of the blood vessels that occurs with diabetes. This results in a reduction of oxygen and nutrient delivery to the tissues and a diminished ability of the immune system to fight infection, including periodontal disease. The second is because many of the bacteria that cause oral infection thrive on the sugar linked to diabetes (glucose). Poor diabetic control can actually feed the bacteria that cause periodontal disease.

Oral symptoms associated with poor diabetic control include:

• Increased tooth mobility
• Dry mouth that can increase the risk for ulcers, root cavities, and infections
• Infections that take longer to heal and are more severe

These symptoms can all be managed with control of blood glucose and improved periodontal health. If the diabetes is well controlled and blood sugar level is within the normal range, the risk of developing periodontal disease is not greater than in people who don't have diabetes. On the flip side, treating periodontal disease reduces the need for insulin on people that have diabetes.

To prevent complications from periodontal disease and diabetes, it is important to maintain normal blood sugar levels and periodontal health. Follow the diet and medication guidelines supplied by your physician and see your dental care provider routinely for periodontal screenings and professional cleanings. Meticulous plaque control is critical. If you have diabetes, your dentist needs to know what your blood glucose level is before starting any dental surgical procedures, and although abscesses and acute dental infections should be treated as soon as possible, non-emergency dental treatment should be postponed until the blood glucose is well controlled.

By Laura Minsk, DMD

Gum Disease and Early Diabetes Detection

In many cases it's the dentist - and not the physician - who has the first opportunity to detect diabetes early, because diabetics are especially prone to dental health problems.

Swollen, tender, receding and bleeding gums, loose teeth, and a sore tongue may not just be signs of poor dental hygiene. They may be danger signals for diabetes, too.

If you have any of these symptoms, you may be one of the estimated 11 million people in North America who already have diabetes, or you may be one of the 600,000 who will be diagnosed this year.

Diabetes occurs when a gland called the pancreas fails to produce sufficient amounts of the hormone, insulin, to regulate blood sugar levels. In other words: Diabetics have too little insulin and too much sugar in their blood.

When this happens, the body tissue can't convert the sugar it needs into energy. The blood stream then fills with this unused sugar and the result is diabetes - a disease medical journals often describe as the "forever" disease.

A serious illness which respects neither age, sex, race nor income level, diabetes is the leading cause of blindness in people 20 to 65 years old and can lead to kidney failure, heart attacks and even death.

But outside the dental community, few people realize that diabetics have more than their share of tooth and periodontal (gum) problems. This fact is especially true for undiagnosed diabetics or those who have failed to control their disease adequately with insulin and/or diet and exercise.

Periodontal disease among diabetics progresses rapidly, recurs frequently, and heals slowly. The resistance to treatment can lead to loosened teeth and premature tooth loss.

Your regular dental office visits provide the best chance for early detection of many health problems, including diabetes. If you have a diabetic tendency, your dentist may very well refer you to your physician - another good reason to keep your prescribed dental recall and dental cleaning appointments faithfully!

If you are diabetic, it's important that you keep your dental health history up-to-date, exercise regularly, and eat a diet that provides good nutrition:

• Have regular meals and snack times. Don't skip meals.
• Avoid sweets (cake, candy, pie, ice cream).
• Limit use of animal fats and trim fat off meats. Avoid butter, cream, egg yolks.
• Bake and broil rather than fry foods.
• Don't use alcohol, wine, or beer without your doctor's permission.
• See your dentist regularly so small dental problems can be taken care of with a local anesthetic.

Teeth don't heal themselves, so small problems turn into big ones if left untreated. Major oral surgery requires a general anesthetic which means "no food prior to surgery" - a problem for diabetics.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.