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Periodontal Disease & Total Body Health


Can gum disease cause health problems beyond my mouth?

Periodontal Disease and Diabetes

Diabetes mellitus is a major medical problem. According to the American Diabetes Association, 25.8million people (8.3% of the population) in the United States are affected with diabetes. Diabetes has dramatic effects on the function of the body’s host defense cells responsible for fighting infections. Periodontal disease is often considered the sixth complication of diabetes, especially when not well controlled. In 2003, the National Institute of Dental and Craniofacial Research reported that people with Type II Diabetes are three times more likely to develop periodontal disease than non diabetic individuals.There are many oral health complications associated with diabetes, which include, gingivitis, periodontal disease, salivary gland dysfunction, increased susceptibility to infections, cavities, abscesses, early loss of teeth, and loss of taste. Diabetes mellitus is considered one of the major risk factors for periodontal diseases. Several epidemiological studies on Type I and Type II Diabetes, conducted by Loe, label periodontal disease as the sixth complication of diabetes (Loe 1993, Diabetes Care) Studies have shown that patients with uncontrolled diabletes experience more extensive and severe periodontal disease than patients who maintain excellent diabetic control. Many long term studies have illustrated that individuals with diabetes are three times for likely to show signs of bone loss, deep pocket depth, tooth mobility, and early tooth loss than healthy individuals (Van Dyke TE 2008 J Periodontol).

Severe periodontal disease can increase blood sugar, thereby increasing a diabetic patient’s risk for complications. Therefore, diabetics who have periodontal disease should be treated to eliminate the periodontal infection. This recommendation is supported by a study reported in the Journal of Periodontology in 1997 involving 113 Pima Indians with both diabetes and periodontal disease. The study found that periodontal infections were treated, the management of their diabetes was noticeably improved.

Several mechanisms have been proposed to explain the greater incidence and severity of periodontal disease in diabetics. Experts suggest the relationship between diabetes and periodontal disease can worsen both conditions if either condition is not properly controlled.

Decrease in host defense: the immune system may not function properly in people with diabetes, thereby increasing the risk of periodontal disease. Diabetes tends to increase susceptibility to bacterial infection by decreasing the effectiveness of cells that kill bacteria.

Enhanced inflammation: Diabetes may cause the production of higher levels of inflammatory cells, which can lead to greater bone loss.

Damage to capillaries: Changes in the small blood vessels seen in the retina and kidney of diabetic patients, can also occur in the periodontium. Damage to the capillaries in the gums may reduce the blood supply and thereby limit the actions of the defense cells in response to bacterial plaque.

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.