Periodontal disease is a complication of diabetes that causes

A strong link between periodontal disease and diabetes has been discovered after many decades of research. That link is understood by both dental and medical professionals to be a two-way connection. Not only can diabetes increase your risk of developing gum disease, if you have gum disease, you may be at higher risk of developing diabetes.

THE PERIO/DIABETES RELATIONSHIP

Diabetes may have an influence on the development of periodontal disease because diabetes can reduce your body’s immune response, which makes you more susceptible to a gum infection. Considering the statistics that in the United States, 29.1 million people have diabetes, 1.7 million new cases are diagnosed each year, and over 8 million people are estimated to have undiagnosed diabetes, its links to gum disease are important to understand.

Periodontal disease is considered the sixth complication of diabetes! That means that having active gum disease can put you at risk for diabetes.  Considering that half of Americans over age 30 have periodontal disease, that means that over 64 million people are at higher risk of developing diabetes.

Because these two conditions are so strongly connected, it is important to understand how they are connected and how you can improve your oral health to reduce your health risks.

HOW DOES DIABETES AFFECT GUM HEALTH?

The risk of periodontal disease in patients with diabetes is directly connected to how well diabetes is controlled. In patients with poor glycemic control, the risk for periodontal disease is increased by 2-3 times. In addition, diabetes contributes to how severe and quickly periodontitis progresses.  

Proper management of your diabetes is crucial for your health and to help reduce your risks for periodontal disease and tooth loss.

HOW DO YOUR GUMS AFFECT BLOOD SUGAR?

The American Dental Association (ADA) published research that suggests gum disease can raise your blood sugar. Their research compared people with healthy gums and people with active gum disease. They found that people who had active gum disease had higher long-term blood sugar levels. Researchers believe that harmful oral bacteria can be introduced into the bloodstream more easily through infected gum tissue. That bacteria, which flows through the bloodstream, triggers your body’s immune system to produce molecules that raise blood sugar. That harmful bacteria can be introduced into your body by simply brushing or eating!

CAN PERIODONTAL TREATMENT HELP CONTROL DIABETES?

Several new studies suggest that periodontal therapies can have positive effects on blood glucose levels. These studies show that patients with diabetes can benefit if their dental professionals and medical providers work in coordination for their diabetes management.

IF I HAVE DIABETES, HOW CAN I HELP IMPROVE MY ORAL AND OVERALL HEALTH?

Yes!

A few simple dental health steps can help to improve your health:

• Good Oral Homecare – Manages harmful bacteria on a daily basis.
• Regular Dental Cleanings – Removes bacterial biofilm from under the gums, which may contribute to active gum disease.
• Periodontal Evaluation – If your dentist suspects that you have gum disease, they will refer you to a highly-qualified periodontal practice where they can offer periodontal therapy to treat your infection.  

If you have already been diagnosed with periodontal disease, you now know how it can be directly linked to diabetes. That is why it is important to make an appointment for an examination and consultation with the premier periodontics center in Central PA. At your appointment, our periodontist in Enola, PA can discuss the links between periodontal disease and diabetes and offer appropriate treatment to reduce risks and optimize your overall health.  

Contact us at 717.972.0031 or online for an appointment.

• Overview
• Prevention
• Living With

Overview

Why are people with diabetes more likely to develop oral health problems?

The link between diabetes and oral health problems is high blood sugar. If blood sugar is poorly controlled, oral health problems are more likely to develop. This is because uncontrolled diabetes weakens white blood cells, which are the body’s main defense against bacterial infections that can occur in the mouth.

Just as studies have shown that controlling blood sugar levels lowers the risk of major organ complications of diabetes — such as eye, heart, and nerve damage — so to can diabetes protect against the development of oral health problems.

What oral health problems are associated with diabetes?

People with diabetes face a higher risk of:

• Dry mouth: Uncontrolled diabetes can decrease saliva (spit) flow, resulting in dry mouth. Dry mouth can further lead to soreness, ulcers, infections and tooth decay.
• Gum inflammation (gingivitis) and periodontitis: Besides weakening white blood cells, another complication of diabetes is that it causes blood vessels to thicken. This slows the flow of nutrients to and waste products from body tissues, including the mouth. When this combination of events, the body loses its ability to fight infections. Since periodontal disease is a bacterial infection, people with uncontrolled diabetes might experience more frequent and more severe gum disease.
• Poor healing of oral tissues: People with uncontrolled diabetes do not heal quickly after oral surgery or other dental procedures because blood flow to the treatment site can be damaged.
• Thrush: People with diabetes who frequently take antibiotics to fight various infections are especially prone to developing a fungal infection of the mouth and tongue. The fungus thrives on the high glucose levels in the saliva of people with uncontrolled diabetes. Wearing dentures (especially when they are worn constantly) can also lead to fungal infections.
• Burning mouth and/or tongue: This condition is caused by the presence of thrush.

People with diabetes who smoke are at an even higher risk — up to 20 times more likely than non-smokers to develop thrush and periodontal disease. Smoking also seems to impair blood flow to the gums, which might affect wound healing in this tissue area.

Prevention

If I have diabetes, how do I prevent oral health problems?

Since people with diabetes are more prone to conditions that might harm their oral health, it’s vital to follow good oral hygiene practices, pay special attention to any changes in your oral health, and to call your dentist immediately if such changes occur. Suggestions to prevent or reduce oral health problems include:

• Keep your blood sugar as close to normal as possible. At each dental visit, tell your dentist the status of your diabetes. For instance, know your glycosylated hemoglobin (HgA1C) level. (Good control is indicated by a level under 7%). If you’ve had an episode of low blood sugar (also called an insulin reaction) in the past, you are at increased risk to have another one. Tell your dentist when your last episode was, how frequently such episodes occur, and when you took your last dose of insulin (if you take insulin).
• See your doctor before scheduling treatment for periodontal disease. Ask your doctor to talk to your dentist or periodontist about your overall health condition If oral surgery is planned, your doctor or dentist will tell you if you need to take any pre-surgical antibiotics, if you need to change your meal schedule or the timing and dosage of your insulin (if you take insulin).
• Make sure to give your dentist your doctor’s name and phone number. This information will then be easily available to your dentist should any questions or concerns arise.
• Bring your dentist a list of all the names and dosages of all medicines you are taking. Your dentist will need to know this information to prescribe medicines least likely to interfere with the medicines you are already taking. If a major infection is being treated, your insulin dose (for those taking insulin) might need to be adjusted.
• Postpone non-emergency dental procedures if your blood sugar is not in good control. However, acute infections (infections that develop quickly), such as abscesses, should be treated right away.
• Keep in mind that healing might take longer in people with diabetes. Follow your dentist’s post-treatment instructions closely.
• Call your orthodontist immediately if a wire or bracket (such as those in braces) cuts your tongue or mouth.

Other oral hygiene tips for people with diabetes:

• Have your teeth and gums cleaned and checked by your dentist at least twice a year. Talk to your dentist to determine how often you will need checkups.
• Prevent plaque buildup on teeth by using dental floss at least once a day.
• Brush your teeth after every meal. Use a soft-bristled toothbrush.
• If you wear dentures, remove them and clean them daily.
• If you smoke, talk to your doctor about ways to quit.

Living With

What are misconceptions about oral health problems and diabetes?

People with diabetes are at greater risk for dental cavities

There are two schools of thought on this topic. One school believes that high glucose levels in the saliva of people with uncontrolled diabetes helps bacteria thrive. This leads to the development of caries (tooth decay or cavities) and gum disease. Also, people with diabetes tend to eat smaller, more frequent meals throughout the day. This increases the chance for bacteria to grow and cavities to develop.

The other school believes that people with diabetes know more about what to eat and the need to closely monitor their sugar intake. They don't eat many foods containing cavity-causing sugar.

The fact is that people whose diabetes is well-controlled have no more tooth decay or periodontal disease than people without diabetes. Good oral hygiene and good blood sugar control are the best protections against cavity formation and periodontal disease.

People with diabetes lose their teeth more often and sooner than people without diabetes

Many factors play a role in the loss of teeth in people with diabetes. First, people with uncontrolled diabetes are more prone to the development of gingivitis and periodontal disease. If the infection persists, it can spread to the underlying bone that anchors the teeth. Complicating this situation is the fact that infections don’t resolve as quickly in people with diabetes.

The good news for people with diabetes is that by practicing good oral hygiene habits — brushing at least twice daily (or preferably after every meal) with a toothpaste that contains fluoride, flossing daily, and keeping blood sugar levels under control — the potential for infection from periodontal disease will be greatly reduced or eliminated, and so will the risk of tooth loss.

If I need oral surgery, I am more at risk for post-surgical problems, including infections, because these are more common in people with diabetes

With close medical care and self-care that keeps blood sugar as close to normal as possible, and good personal and professional dental care, problems after surgery are no more likely in people with diabetes than in those without the disease.

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