Local Dental Care - Gingivitis Causes

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

Dental Procedure For Dental Recession

Dental recession is a displacement of the gum around the teeth that results in greater tooth exposure and a longer looking tooth. As the gum that protects the root surface of the tooth is lost, not only does it create an esthetic deformity, it makes the tooth more sensitive to changes in temperature (hot and cold), touch, and to proper oral hygiene techniques. The exposed root surfaces also are more susceptible to cavities. Causes of dental recession include:

• Periodontal disease: The bacteria that cause gingivitis can release toxins that injure the gum tissues and create gum recession. Once the gum is affected by gingivitis (see article "Gingivitis"), it is even more susceptible to further dental recession and bone loss. So if the gum is red, swollen, or bleeds when probed, it is more likely to continue receding. Eventually, there may not be enough healthy gum and bone left to protect the tooth and the tooth may need to be removed. If there is less than 2 mm of healthy gum in an area of recession, a dentist may recommend a gum graft to help prevent further receding gums and help protect the tooth.
• Trauma: Medium or hard bristle toothbrushes, brushing too hard, or brushing inappropriately can damage the teeth and the gums. It is very important to use a soft bristle toothbrush when cleaning the teeth, and to follow proper technique. Mechanical trauma to the gums also can be caused by improperly fitting dental restorations or dentures. Fillings that are rough or dentures that are loose or poorly designed can injure the gums and cause them to recede.

Gums also may recede as a result of orthodontic treatment or from manipulation during restorative procedures. To prevent this from occurring, a dentist may recommend gum grafting before orthodontics or restorative treatment.

Gum grafts are indicated if an individual has root sensitivity to touch or temperature changes, if new restorative work will be done in the area of the dental recession, if the roots are susceptible to cavities, or if an individual is having problems following proper plaque control procedures. In addition, gum grafts are cosmetic periodontal procedures that can be performed to enhance smiles if recession has created esthetic problems such as long teeth or exposed roots.

By Laura Minsk, DMD