The Link Between Gum Disease and Diabetes

It is well documented that people who suffer from diabetes are more susceptible to developing infections than non-diabetes sufferers.  It is not widely known that gum disease is often considered the sixth complication of diabetes;  particularly when the diabetes is not under proper control.

Gum disease (often called periodontitis and periodontal disease) is a progressive condition that often leads to tooth loss if treatment is not promptly sought.  Periodontal disease begins with a bacterial infection in the gingival tissue which surrounds the teeth.  As the bacteria colonize, the gum pockets become deeper, the gums recede as tissue is destroyed and the periodontitis eventually attacks the underlying bone tissue.

Diabetes is characterized by too much glucose (or sugar) in the blood.  Type II diabetics are unable to regulate insulin levels which means excess glucose stays in the blood.  Type I diabetics do not produce any insulin at all.  Diabetes is a serious condition which can lead to heart disease and stroke.

Reasons for the Connection

Experts suggest the relationship between diabetes and periodontal disease can worsen both conditions if either condition is not properly controlled.

Here are ways in which diabetes and periodontal disease are linked:

• Increased blood sugar – Moderate and severe periodontal disease elevates sugar levels in the body, increasing the amount of time the body has to function with high blood sugar.  This is why diabetics with periodontitis have difficulty keeping control of their blood sugar.  In addition, the higher sugar levels found in the mouth of diabetics provide food for the very bacteria that worsen periodontal infections.
• Blood vessel thickening – The thickening of the blood vessels is one of the other major concerns for diabetes sufferers.  The blood vessels normally serve a vital function for tissues by delivering nutrients and removing waste products.  With diabetes, the blood vessels become too thick for these exchanges to occur.  This means that harmful waste is left in the mouth and can weaken the resistance of gum tissue, which can lead to infection and gum disease.
• Smoking – Tobacco use does a great deal of damage in the oral region.  Not only does tobacco use slow the healing process, it also vastly increases the chances of an individual developing periodontal disease.  For diabetics who smoke, the risk is exponentially greater.  In fact, diabetic smokers aged 45 and over are twenty times more likely to develop periodontal disease.
• Poor oral hygiene – It is essential for diabetics to maintain excellent levels of oral health.  When daily brushing and flossing does not occur, the harmful oral bacteria can ingest the excess sugar between the teeth and colonize more freely below the gum line.  This exacerbates the metabolic problems that diabetes sufferers experience.

What Dental Problems Does Diabetes Cause?

Patients with Type I and Type II diabetes exhibit a variety of symptoms all over the body, including in the mouth.  These can lead to more severe oral health problems, such as gingivitis, periodontal disease, and dry mouth, among other issues.  These oral health problems caused by diabetes range from mild to severe and can include the following.

Diabetes and tooth decay

With increased blood glucose levels, people living with diabetes may have more glucose in their saliva and very dry mouths.  These conditions allow dental plaque to build up on teeth, which leads to tooth decay and cavities.

Dental plaque can be successfully removed by thoroughly cleaning your teeth and gums twice daily with a toothbrush and fluoride toothpaste.  Use interdental cleaners or dental floss daily to clean between your teeth.  Taking good care of your teeth prevents cavities and gum disease.

Diabetes and oral fungal infections

Oral thrush (candidiasis) is a fungal infection.  It is caused by an overgrowth of the yeast, Candida albicans, which occurs naturally in the mouth.  Some conditions caused by diabetes such as high glucose in saliva, poor resistance to infection and dry mouth (low saliva levels) can contribute to oral thrush.

Oral thrush causes white or red patches on the skin of the mouth, which can result in discomfort and ulcers.  Good mouth hygiene and optimal blood glucose levels are critical to successfully treating oral thrush.  Our dentist can treat this condition by prescribing antifungal medications.

Caring for your teeth and gums

If you are a person living with diabetes, and wish to prevent tooth and gum problems, it is advisable to:

• Follow your doctor’s advice about diet and medication to keep your blood glucose levels as close to optimal levels as possible.
• Thoroughly clean your teeth and gums twice a day with toothpaste that contains fluoride.
• Use dental floss or interdental cleaners every day to clean between your teeth.
• Visit your dentist regularly for advice about proper home care, early intervention and regular preventive maintenance visits to keep your teeth and gums healthy.  Your dentist will want to know what your blood glucose levels are and what medications you are taking.
• Avoid having a dry mouth – drink plenty of water and chew sugar-free gum to stimulate saliva production.
• Don’t smoke – speak to your doctor or call Quitline Tel. 13 7848 (13 QUIT) for guidance and support.

Schedule an Appointment

Just as crucial as your brushing and flossing routine is making regular trips to the dentist, and that might mean more than the standard two appointments a year.  To play it safe, we recommend three or four yearly visits for diabetic patients.  It is also essential that your doctor and your dental health care provider have the right information to be able to work as a team to keep you, your teeth, and your gums healthy.  If you have Diabetes, we encourage you to one of our Beaufort dentist and he or she can design a personalized program for treating oral care to meet your needs.  Call 843-986-0177 or schedule an online appointment.