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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

Periodontal Disease: Leading Cause of Adult Tooth Loss

Periodontal disease is a bacterial infection. Without proper dental care the bacteria that are present in plaque can infect the gums (gingivitis) and destroy the bone and tissues that support the teeth in what is called periodontitis-- the leading cause of tooth loss and bad breath (halitosis) in adults. In addition, gum disease has been linked to more serious health threats such as diabetes, cardiovascular disease, respiratory disease, and pre-term, low-birth weight babies.

Is periodontal disease contagious? Can it be passed from one person to another like tuberculosis or meningitis? Can you get periodontal disease by kissing someone who has it? The answer to all these questions is YES.

In a dental care article published in the Journal of the American Dental Association, it was revealed that periodontitis might be passed from parents to children and between intimate partners.

The bacteria that inhabit the periodontal pockets are also present on the oral soft tissues, teeth, tongue and saliva. They can be transferred from one person to another through saliva, intimate kissing, sharing of food, utensils, or toothbrushes, and can result in exposure to saliva that contain the bacteria that cause periodontal disease.

Based on these findings and the fact that periodontal disease has a genetic component, it is recommended that if one family member has periodontitis, all family members see a dental care professional or periodontist for a periodontal screening. Parents need to know that gum disease and halitosis are not just adult health problems and that children can also be affected.

To prevent transmission of periodontitis between family members or intimate partners, it is important to follow proper dental care and oral hygiene techniques that include daily brushing and flossing and to see a dental care provider routinely for professional cleanings and examinations.

By Laura Minsk, DMD

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