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Periodontal 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 t periodontal disease is often considered the sixth complication of diabetes; particularly when the diabetes is not under proper control.

Periodontal disease (often called periodontitis and gum 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.

Diagnosis and Treatment

It is of paramount importance for people suffering from any type of diabetes to see the dentist at least twice yearly for checkups and professional cleanings.  Studies have shown that simple non-surgical periodontal treatments can lower the HbA1c (hemoglobin molecule blood test) count by as much as 20% in a six month period.

The dentist will use medical history, family history and dental X-rays to assess the risk factors for periodontal disease and determine the exact condition of the gums, teeth and underlying jawbone.  If necessary the dentist will work in conjunction with other doctors to ensure that both the diabetes and the gum disease are being managed and controlled as effectively as possible.

Non-surgical procedures performed by the dentist and dental hygienist include deep scaling, where calculus (tartar) will be removed from the teeth above and below the gumline, and root planing, where the root of the tooth is smoothed down to eliminate any remaining bacteria.  Antibiotics may be applied to the gum pockets to promote healing.

Before and after periodontal treatment, the dentist and hygienist will recommend proper home care and oral maintenance as well as prescribing prescription mouthwashes which serve to deter further bacteria colonization.

If you have questions or concerns about diabetes or periodontal disease, please ask your dentist.

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Testimonials

Dr. Carpenter,



So many times in business and life in general, we are pummeled with the negative. I just wanted to drop a quick positive note to let you know how pleased I am with yourself and the entire staff at M Street Dental. My entire family have been patients with you for many years. I don’t believe anyone will tell you they enjoy going to the dentist and I will confess I am no exception. M Street Dental however has always maintained a genuinely positive and friendly atmosphere where I feel as though I am among friends. This includes your entire staff. On Thursday, January 17th, I went into your clinic expecting to have a what was left of a tooth that had broken off extracted. To my pleasant surprise you have put me on a treatment plan to basically “resurrect” this tooth. Keep up the great work & kudos to you all.

Brian Buckingham

When I asked for an evaluation of my mouth, I thought I would probably lose all my remaining teeth, and start over. Remarkably you immediately removed the remains of 2 teeth and set up time the next day to make impressions. Your assistant made very good impressions, and made time the next day for your lab people to add to and repair my existing partial plates. A great job by all of you! The fit is amazing, and they work almost as well as normal teeth. They have needed no adjusting and I can eat green salad again, and apples! And the teeth that show in a smile look very natural. Thank all of you for a good job, well done. It is much appreciated! All done in 4 days!! Unbelievable! Thank you very much.

June Cheek

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