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

Periodontal disease (often called periodontitis or gum disease) is a progressive condition that often leads to tooth loss if treatment is not promptly sought.  It begins with a bacterial infection in the gum tissues surrounding the teeth.  As the bacteria colonize, the infection becomes deeper and causes the gums and jawbone to receed. 

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 – 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, weakening the gums and leading to infection and bone loss. 
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• Smoking – Tobacco use does a great deal of damage in the oral region.  Not only does it 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 hygiene.  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 gumline.  This exacerbates the metabolic problems that diabetes sufferers experience.

Diagnosis and Treatment

It is extremely important for people suffering from diabetes to see the dentist at least twice yearly for checkups and professional cleanings.  Your periodontist will use your 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 periodontist 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 periodontist and dental hygienist include scaling (removing calculus from the teeth above and below the gumline) and root planing (removing calculus and bacterial endotoxins from the root surface).  Antibiotics may be applied to pockets of infection to promote healing.

Before and after periodontal treatment, your periodontist and hygienist will recommend proper home care and oral maintenance as well as prescribing topical medications to deter further bacteria colonization.

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