09Sep

Blood glucose control and good oral hygiene seems to be the key to avoiding most dental complications. Everyone is at risk of developing periodontal disease, but all people with diabetes, regardless of age or type of diabetes, are more susceptible. There are several reasons for this.
For one, people with diabetes have more sugar in the mouth which provides a more hospitable environment for hostile bacteria. This makes all forms of periodontal disease, as well as tooth decay more likely.

High and fluctuating blood glucoses are also a big factor in the increased risk of periodontal disease. Poor blood glucose control means higher degrees of periodontitis and more vulnerability to complications.

It also makes healing more difficult once an infection sets in. Just like diabetics with poor blood glucose control have a hard time healing wounds and infections on their feet, their bodies have a hard time fighting infections and healing wounds in the mouth.

At the same time, on-going infections may make blood glucose control more difficult. Inflammation and infection affect blood glucose control no matter where they occur. But the mouth is often overlooked as most doctors do not look in the mouth.  Once an infection takes root a vicious cycle ensues making metabolic and infection control a struggle.

This cycle can have drastic consequences. If oral infections get out of control they can lead to blood glucose control problems serious enough to land a person with diabetes in the hospital, to say nothing of the damage to the teeth and gums.

Gum infections can also impact insulin needs. Authors of a study cited in September's 1997's Practical Diabetology concluded that when an infection is rampant, patients with diabetes often have increased insulin requirements. If periodontal disease is treated and gingival inflammation is eliminated, these insulin needs often decrease.

Collagen, which is a building block of the tissue that attaches teeth to bones and the surrounding soft tissue, is also affected by diabetes. Diabetes' effect on collagen metabolism, according to Finney, "may make an infection potentially more destructive."

02Sep

Defining Periodontitis

by Dr. McBride

 Periodontitis- gum, or periodontal disease - involves inflammation and destruction of the tissues supporting and surrounding the teeth, including the gums and supporting bone. Periodontitis destroys the periodontal ligaments or connective tissue fibers that attach the tooth to the bone causing resorption (destruction) of the alveolar bone (tooth socket). Consequently, the gums swell, redden, change shape, bleed, teeth loosen and pus forms. With the loss of soft tissue and bony support, deep periodontal pockets may form that foster bacterial growth.  The sad thing about all this is the fact that there is no pain involved in the process.

31Aug

Diabetes and Gum Disease

by Dr. McBride

Diabetes is a complex disease with both vascular and metabolic components. A back and forth connection exists between diabetic control and oral infections. When gum disease (periodontal  infection) is established, metabolic control of diabetes is worsened. When diabetes is worsened, gum disease progresses.
People with diabetes are twice as prone to gum disease.  The link between diabetes and oral health can't be ignored (see The Scottsdale Project Report).  In fact, dental problems in people with diabetes are so rampant that some believe oral disease should be referred to as "the sixth 'opathy' of diabetes," deserving of the attention given to retinopathy, neuropathy, nephropathy and the like.

Gums affected by gingivitis often bleed and are sensitive, but not always. Other signs include swollen gums, loose teeth, a bad taste in the mouth and persistent bad breath.
While everyone is prone to periodontitis, or diseases of the tissues surrounding the teeth and gums, people with diabetes often have more severe cases that can both cause and predict additional diabetic complications.