Periodontal Disease and Diabetes

The association between diabetes and periodontal disease is well-documented. People with diabetes are more susceptible to infections, and periodontal disease is often considered the sixth complication of diabetes, particularly when the diabetes is not properly controlled.

Periodontal disease, also known as periodontitis and gum disease, is a progressive condition that can lead to tooth loss if left untreated. It begins with a bacterial infection in the gingival tissue surrounding the teeth, which causes the gum pockets to deepen, gums to recede, and eventually leads to damage to the underlying bone tissue.

Diabetes is characterized by elevated glucose levels in the blood. Type II diabetics have difficulty regulating insulin levels, resulting in excess glucose in the blood. Type I diabetics do not produce insulin at all. Diabetes is a serious condition that can increase the risk of heart disease and stroke.

There are several reasons for the connection between diabetes and periodontal disease, and both conditions can worsen if not properly controlled:

1. Increased blood sugar: Moderate to severe periodontal disease elevates sugar levels in the body, making it challenging for diabetics to control their blood sugar. The higher sugar levels in the mouth provide nourishment for bacteria that worsen periodontal infections.

2. Blood vessel thickening: Diabetes thickens blood vessels, impeding the exchange of nutrients and waste products. This can weaken gum tissue resistance, leading to infection and gum disease.

3. Smoking: Tobacco use significantly increases the risk of periodontal disease. For diabetics who smoke, the risk is even greater. Diabetic smokers aged 45 and over are twenty times more likely to develop periodontal disease.

4. Poor oral hygiene: Maintaining excellent oral health is crucial for diabetics. Inadequate brushing and flossing allow harmful oral bacteria to thrive, leading to further complications below the gum line and exacerbating metabolic issues in diabetes.

Diagnosis and treatment of periodontal disease in people with diabetes is essential. Regular check-ups and professional cleanings are recommended at least twice a year. Non-surgical procedures such as deep scaling and root planing are performed to remove calculus and bacteria. Antibiotics may be used to promote healing.

Before and after treatment, the dentist and hygienist will provide guidance on proper home care and oral maintenance. Prescription mouthwashes may be prescribed to inhibit bacterial colonization and support long-term oral health. Collaborative efforts between the dentist and other healthcare professionals are essential to effectively manage both diabetes and periodontal disease.