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Periodontitis: The 6th Complication of Diabetes

Diabetes effects all populations and is becoming a ‘global epidemic’ with many cases (possibly up to 50%) remaining undiagnosed. It is a common health problem that if not controlled can have many serious health effects which in turn can lead to lower life expectancy, complications include:

  • Cardiovascular disease (major cause of death) and peripheral vascular disease (amputations)
  • Cerebrovascular disease and stroke
  • Retinopathy (blindness)
  • Nephropathy (renal failure)
  • Neuropathy (painful nerve damage)
  • Periodontal disease

Periodontal diseases are one of the most common diseases in humans and although diabetes and periodontal diseases may seem unrelated we know that people who suffer with diabetes have a two-fold or greater risk of developing periodontal diseases. Due to the increased prevalence and severity of periodontitis seen in diabetic patients with poor glycaemic control, periodontitis has been identified as ‘the 6th complication of diabetes’.

Well controlled diabetes is not a risk factor for periodontitis, however if it is not well controlled patients can develop a more severe and extensive form of periodontitis. Studies have demonstrated that the presence of one condition adversely effects the other – there is a bidirectional relationship between the two conditions. As well as periodontal diseases there are other possible oral complications of diabetes including:

  • Reduced salivary flow
  • Burning mouth or tongue
  • Increased candida infections
  • Angular chelitis
  • Taste disturbance
  • Oral lichen planus
  • Multiple periodontal abscesses
  • Denture-induced stomatitis

How does Diabetes affect Periodontitis?

Diabetes can impair the healing response throughout the body and this can also apply to the healing following periodontal treatment, making treating periodontitis in a diabetic patient more difficult.

How does Periodontitis affect Diabetes?

Severe periodontitis adversely effects glycaemic control in diabetics and there is a direct link between periodontitis severity and diabetes complications. The mechanism by which periodontitis affects diabetes is not yet completely understood but scientists think that when periodontitis is present the mouth is a significant source of bacteria, these bacteria cause a reaction in the body that results in our defence system being activated. Molecules released due to this defence reaction have the ability to suppress insulin and therefore lead to elevated blood glucose levels.

What effect will treatment of Periodontitis have on Diabetes?

Periodontal treatment and control of periodontal inflammation has been shown to improve glucose control, it is thought that this is due to treatment reducing the number of circulating defence molecules. This means that if you have diabetes, improving your gum health may help to control your diabetes and reduce the risk of diabetes complications. If there is a history of diabetes in your family, having your gums checked for signs of diabetes, treating gum disease alongside losing weight and taking exercise may help you to stay healthy.

Preventing Dental Problems Associated with Diabetes

  • First and most importantly you need to control your blood glucose levels, always inform us of your most recent HbA1c test. HbA1c is a blood test that measures the proportion of glucose bound to the haemoglobin in the red blood cells and indicates the diabetes control over the last 8-10 weeks, it therefore provides us with a better idea of your diabetes control and how this may affect your periodontal condition.
  • Take good care of your teeth and gums by ensuring you attend appointments regularly as advised by your dental professional
  • Follow the tailored oral hygiene instructions provided to you to ensure you effectively remove bacterial plaque from the mouth
  • To control and prevent candida infections maintain good blood glucose control, avoid smoking, and if you wear them remove dentures and clean well twice daily
  • Prevent the reduction of saliva flow and a dry mouth by keeping blood glucose levels well controlled
  • Schedule your appointments around your normal eating routines and do not miss a meal or taking/administering your medication

Thank you for consulting Pure Periodontics for your gum and periodontal health. We look forward to the opportunity to provide the highest level of periodontal care that enables our patients to achieve optimal oral health improvement outcomes.