ORAL HEALTH AND DIABETES

Diabetes is a chronic, incurable illness and a growing epidemic in the United States and Canada. More than 30 million Americans and about 3 million Canadians have diabetes. Prediabetes is even more common and, while reversible with treatment and management, most people with prediabetes don’t know they have it. Diabetes affects the body’s ability to control the production of insulin, a hormone that enables the body’s cells to use sugar. Type 1 diabetes is when the body makes little to no insulin, which can lead to hyperglycemia (high blood sugar). In Type 2 diabetes, which accounts for roughly 90% of diabetes cases, the cells of the body develop a resistance to insulin, also leading to high blood sugar levels. Patients with Type 2 diabetes can control their blood sugar levels through medication, nutrition, lifestyle changes and careful monitoring. If left unchecked, Type 2 diabetes can lead to a variety of systemic consequences, including damage to your heart, eyes, kidneys and nerves.

What do I need to know about the link between diabetes and periodontal disease?

Patients with high blood sugar can be three times more likely to develop periodontitis than those without diabetes. Diabetes doesn’t just lead to periodontal disease — the two have a bidirectional relationship, meaning the presence of one condition can impact the other. Studies show that patients with severe periodontitis have higher blood sugar levels and may be at a higher risk of developing Type 2 diabetes. Patients who are already diabetic may also have a harder time controlling their blood sugar levels if they have active periodontal disease.

Over time, periodontitis causes your gums to pull away from your teeth (attachment loss). The deep periodontal pockets created allow the disease-causing bacteria to infiltrate the underlying bone and connective tissue, eventually leading to tooth loss. In fact, one in five cases of total tooth loss is linked to diabetes. It is important to establish a periodontal regiment with your dentist and maintain it

What other oral health problems are associated with diabetes?

Alveolar bone loss.
• Abscess formation.
• Poor wound healing.
• Dry mouth.
• Burning sensation in the mouth.
• More frequent and severe infections.
• Thrush (oral yeast infection).
• Parotid salivary gland enlargement.
• Gingivitis.
• Tooth decay (caries or cavities).
• Tooth mobility.
• Tooth loss.

How can my dentist help?

If you have a history or diabetes, your dentist may want to evaluate you for periodontal disease; likewise, if you have signs and symptoms of periodontal disease, your dentist may recommend screening for diabetes. Some dentists may be able to provide diabetes screening themselves, while others may refer you to your primary physician for testing and evaluation. If you have both diabetes and periodontal disease, your dentist can help — several studies have confirmed that effective periodontal therapy can improve glycemic control. Your dentist can become a valuable partner in maintaining your overall level of health, even working with your primary physician and/or endocrinologist to help monitor your health.