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Bleeding Gums

If you have bleeding gums, you may have periodontal disease. We're learning more about this common infection all the time. Below are some of the latest findings. It should help you understand why it's so important that you take action with your periodontist to eliminate periodontal disease, the sooner the better.

Some patients think swollen gums aren't as critical as tooth decay, but that's just not so. Periodontal disease begins as a minor infection and, if it doesn't show signs of stabilizing, is bound to get worse. Untreated, it can eventually result in tooth loss.

Type I periodontitis (gingivitis) consists of tender gums and a little bacteria-filled pocket between your tooth and gum. The disease is very treatable at this point. But if the infected pockets are allowed to enlarge, the inflammation extends to the bone beneath, which begins to erode.

There's another reason to take periodontal disease seriously. The Journal of the American Dental Association recently reported on a study of nonsmokers. Researchers found that periodontal disease was a stronger risk factor for heart disease than such typical symptoms as high cholesterol or high blood pressure. Also, periodontitis in pregnant mothers has been linked to premature and low birth-weight babies.

Your periodontist's concerns for your health don't stop with your teeth. That's why it's important, if you're suffering from gingivitis, that you schedule an appointment and get it treated. When you do, make sure you let your dentist know if you are also being treated for heart disease by your medical doctor.

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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