Periodontal Disease and Diabetes

Periodontal disease is a common inflammatory condition caused by bacteria. Initially, it was once thought only to affect the mouth, but we now know that periodontal disease can potentially play an important role in many other serious conditions affecting the entire body and which include diabetes.

What Exactly Is Periodontal Disease?

Your mouth is full of bacteria, and it contains hundreds of species at any given time. Many of these species are benign and will not harm you, but others aren’t quite so kindly. Unless these harmful bacteria are removed regularly, they can quickly build up into unmanageable levels. When this occurs, the bacteria can infect and harm your gum tissue, and without the proper professional dental care, they can spread beyond your mouth. Of course, your body will try to fight this infection as it prompts an immune response, but unfortunately, it’s this immune response that causes inflammation and which ultimately becomes chronic. 

Initially, inflammation can be helpful, but when it is prolonged or chronic, it can cause harm and will begin to destroy your gum tissues. As your gums become more infected and inflamed, they begin to bleed, and this is one of the first warning signs that something is wrong with your gum health. The problem with bleeding is that it allows these harmful bacteria to spread from your gums into other tissues, including the ligaments and bone surrounding your teeth. As the bacteria spread into these tissues, they gradually begin to destroy these as well, eventually causing your teeth to loosen. This is why severe periodontal disease is the major cause of tooth loss. What’s worse is that once your gums do begin to bleed, these bacteria have easy passage into your bloodstream, and they can begin to affect your overall health.

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The inflammation caused by periodontal disease is associated with other systemic inflammatory conditions and which include cardiovascular disease, increasing your risk of heart problems, including heart attacks and stroke. Periodontal disease has also been associated with preterm births, and with other serious health problems, including rheumatoid arthritis, respiratory diseases, and some cancers. We now also know that periodontal disease can negatively affect blood sugar levels, and that excellent periodontal therapy can help to improve blood sugar control.

What Is Diabetes?

Diabetes or diabetes mellitus is derived from ancient Greek and means to pass through urine. It is a condition that results in high blood glucose levels and is caused by hereditary or environmental factors. Glucose is the body’s primary source of energy, and it’s partly controlled by the hormone insulin and which is made in the pancreas. People develop diabetes when insulin production is diminished, and this can cause type I diabetes. Resistance to insulin and its effects can cause type II diabetes and gestation or pregnancy diabetes. Unfortunately, rates of diabetes have been increasing substantially over the last couple of decades. It’s estimated there are more than 23 million people with diabetes in the US alone, and there may be as many as 6 million people who are underdiagnosed.

Additionally, approximately 41 million people have prediabetes, a condition that can potentially progress into type II diabetes. Just 5 to 10% of people have type I diabetes, while the rest are type II. All types of diabetes are treatable, but there isn’t a cure. However, while people with type I diabetes need insulin to survive, people with type II diabetes can often manage their condition with insulin supplements, and by modifying lifestyle factors such as exercise and diet.

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How Can Periodontal Disease Affect Diabetes?

Periodontal disease develops if you don’t practice good oral hygiene, but only around 10 to 15% of people will develop advanced periodontal disease that can eventually cause tooth loss. The problem with both these diseases is that periodontal disease can make it difficult to control blood glucose levels, increasing the risk of diabetes. When people have diabetes, it’s more likely they will have higher levels of glucose in their saliva, which is the perfect fuel for the bacteria that cause periodontal disease.

If you already have been diagnosed with diabetes, you will almost certainly need to see your dentist at regular intervals, and they may suggest you have your teeth cleaned professionally more frequently. Keeping your mouth clean and free from disease-causing bacteria is the best way to prevent periodontal disease. However, it may also be worth seeing a periodontist, a specialist in the diagnosis and treatment of problems affecting the supporting structures of your teeth and which include your gums, ligaments, and jawbone. A periodontist can screen you far more thoroughly for signs of periodontal disease and if needed, can provide you with far more advanced periodontal therapy than is available in your local dental office. 

If you are diagnosed with advanced periodontal disease, it’s worth seeing a periodontist, and your dentist may even choose to refer you to the specialist. The periodontist can carry out a complete periodontal evaluation and can provide you with a custom treatment plan designed to help control this condition. The treatment plan may include nonsurgical and surgical procedures designed to remove the maximum amount of bacteria from your mouth. If you also have diabetes, they may suggest blood sugar testing before and after treatment to evaluate the effects of periodontal therapy. It’s also important to let your periodontist know if you have a family history of diabetes, even if you don’t have the disease.

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Preventing Periodontal Disease

Prevention is always better than the cure, and it is possible to maintain healthy gums, even if you have diabetes. When you initially visit a dentist or periodontist for an evaluation, they can also discuss your daily oral health regime. It is crucial to maintain a clean mouth and to ensure you brush at least twice a day and floss once-a-day. However, even though some people brush twice a day, they may not do it thoroughly enough or will not brush for the full two or three minutes. It’s a common mistake to make, so next time you brush your teeth, pay attention to the way you brush, making sure you clean all your tooth surfaces methodically. If you don’t use an electric brush with a built-in timer, try timing yourself as you may be surprised! Also, don’t forget to floss. Hate flossing? Ask your dentist for help as they will be delighted and pleased to work with you to improve your flossing skills.

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