Diabetes and Periodontal Disease

The two-way relationship between periodontal disease and diabetes…

For years we’ve known that people with diabetes are more likely to have periodontal disease than people without diabetes. Recently, research has emerged suggesting that the relationship goes both ways – periodontal disease may make it more difficult for people who have diabetes to control their blood sugar.

More research is needed to confirm how periodontal disease can make it more difficult to control blood sugar. What we do know is that severe periodontal disease can increase blood sugar, contributing to increased periods of time when your body functions with a high blood sugar. And, as a diabetic, you know that this puts you at increased risk for diabetic complications.

In other words, controlling your periodontal disease may help you control your diabetes.

If you are among the nearly 16 million Americans who live with diabetes, or are at risk for periodontal disease, see a periodontist for a periodontal evaluation — because healthy gums may lead to a healthier body.

Why is oral health so important to me as a diabetic?

Periodontal disease (also known as gum disease) is a bacterial infection that, when left untreated, may increase in severity. As a diabetic, you are at a higher risk for developing these types of infections, which can impair your ability to process and/or utilize insulin. This may cause your diabetes to be more difficult to control and your infection to be more severe than a non-diabetic.

What other oral conditions am I at risk for as a diabetic?

In addition to increased susceptibility to periodontal disease, diabetics, especially uncontrolled diabetics, may experience one or more of the following:

Delayed wound healing
Any type of wound usually takes longer to heal in diabetics than in non-diabetics.

Decreased or diminished flow of saliva
Reduction in saliva may lead to an increased amount of plaque and calculus. This, in turn, may increase your chances for developing periodontal disease and cavities. Some medications can also contribute to reduced saliva production.

Burning sensation in the mouth or on the tongue
This is a common complaint among uncontrolled diabetics.

Increased sugars in the gingival fluid
Some studies indicate that sugars in gingival fluid (the fluid in the space between the gum and tooth) can contribute to increased plaque, as well as the development of periodontal disease and cavities.

Conversely, studies show that well-controlled diabetics have a lower incidence of cavities than uncontrolled diabetics or non-diabetics. This is probably a result of a diet low in refined sugars and careful attention to oral health.

What steps can I take to prevent gum disease?

To prevent periodontal disease, you must remove the plaque from your teeth and gums every day by brushing and flossing. Review how you brush and floss with your dentist, Dr. Anne Nicholas, and her dental hygienist. They can help you fine-tune your technique so that your at-home efforts are even more effective. Regular dental visits are also important. Daily cleaning will keep calculus formation to a minimum, but won’t completely prevent it.

A professional cleaning at least twice a year is necessary to remove calculus from places your toothbrush, floss, and other cleaning aids may have missed. If you’ve had periodontal disease and it has been treated, you may need professional clearings more frequently.

When you visit your dentist, you need to make him or her aware of your diabetes. You should always provide him or her with a medical history that is comprehensive and accurate. It is equally important to let your physician know about your periodontal status because, as previously stated, any infection can have a significant impact on your diabetes.

Finally, maintaining control of your blood sugar levels will help you resist a periodontal infection.

What should I do if I have periodontal disease?

If detected early, a periodontist (a dentist who specializes in the prevention, diagnosis, and treatment of periodontal diseases) can provide treatment that may arrest your gum disease and bring your gums back to a state of health.

If your diabetes is well controlled, your periodontal treatment will be similar to non-diabetic patients. In the early stages of gum disease, treatment usually involves scaling and root planing. Be sure to eat a normal breakfast in order to stabilize and prevent a severe or sudden drop in your blood sugar levels.

If you are having problems keeping your diabetes under control, your periodontal treatment will be less predictable and may take longer to heal. Your periodontist and physician will need to work together to help you control both your diabetes and your gum disease.

What can I do to monitor my oral healthcare?

You should contact your dentist or periodontist if you notice any of the following symptoms:

  • Bleeding gums during brushing
  • Red, swollen, or tender gums
  • Gums that have pulled away from the teeth
  • Persistent bad breath
  • Pus between the teeth and gums
  • Loose or separating teeth
  • A change in the way your teeth fit together when you bite
  • A change in the fit of partial dentures

You may have periodontal disease and not have any of these symptoms. Most people don’t experience pain with periodontal disease. That’s why it is important to have regular dental checkups, including a periodontal examination. To learn more about care for diabetes and periodontal disease in Palm Desert, California, please call us today.