Diabetes can affect many bodily systems such as the eyes, heart, and nerves but there’s also a link between diabetes and gum disease. What makes this particularly hard to manage is that the link between the two goes both ways. Gum disease is a complication of diabetes but diabetes is also a complication of gum disease.
According to the American Diabetes Association, one third of adults with diabetes are undiagnosed. Diabetes is the #3 cause of death in the United States behind Cardiovascular Disease and Cancer so it’s alarming that up to one third of those who have it, don’t even know that they do.
You may be surprised to know that your dentist plays a key role in diabetic care and is often the first person to alert you that you’re showing signs of being a diabetic. The reason for this is that many diabetes symptoms and complications show themselves in your mouth and teeth.
How Does Diabetes Contribute to Gum Disease?
When glucose (blood sugar) levels are high in the body, it also causes glucose to be high in the saliva. For reasons that aren’t entirely known, high blood sugar levels also cause dry mouth, also called xerostomia.
One of the purposes of saliva is to keep the mouth moist. It also serves to help wash away food particles and plaque that adheres to teeth after eating or drinking. Without enough saliva, more plaque clings to the teeth and gums and sets up colonies of bacteria in the cracks and crevices between teeth and along the gum line.
If you have uncontrolled diabetes, the saliva in your mouth will have high levels of glucose (sugar) in it. This creates a double-whammy! Mouth conditions are dry and sticky which promote bacteria growth AND the saliva that is present is high in sugar. Bacteria thrive on sugars which include glucose which is the sugar linked to diabetes.
Stages of Gum Disease
The three stages of gum disease are Gingivitis, Mild Periodontitis, and Advanced Periodontitis.
There may be no symptoms associated with Gingivitis other than occasional mild bleeding that can occur with brushing or flossing. As gum disease progresses, more symptoms will appear which can include:
- Tender and swollen gums
- Receding gums
- Bad breath
- Formations of pockets between teeth and gums
- Shifting or loose teeth
- Tooth loss
- Bone loss in the alveolar areas (this is where the teeth are anchored in the jaw)
Periodontitis is an infection of the tissues that hold the teeth in place. This can start out in the gums but progress to the jaw.
Another type of chronic, oral infection that can be caused by diabetes is a condition called Thrush, also known as Oral Candidiasis which is a yeast infection of the mouth. It’s normal to have candida present in the mouth, but with Thrush, it multiplies and grows out of control.
Symptoms include white-colored lesions that appear on the tongue and inner cheek areas. It can spread to the roof of the mouth, throat, and even the esophagus. If severe enough, eating and swallowing may cause pain or a burning sensation.
Thrush is usually a minor infection but if the immune system is weakened like it is in a diabetic patient, the condition can be chronic and difficult to control.
It is important to note that diabetic complications of gum disease usually only develop in those individuals whose blood sugar is not under control and/or for those patients who smoke. In fact, people who are able to keep their blood sugar under control have no more risk for gum disease than people who don’t have diabetes.
Why Your Dentist is Instrumental in Managing Your Diabetes
What makes gum disease particularly dangerous in diabetics is that infections of the mouth can CAUSE blood sugar to spiral out of control and can actually accelerate the advancement of diabetes. Additionally, people who have diabetes with infections or wounds are slower to heal.
Because of this, diabetes management necessitates ongoing communication between your medical providers which should always include your dentist. Dr. Guillory and Dr. Lopez are both knowledgeable about the techniques needed to both diagnose and treat disorders in patients who have diabetes. For more information regarding diabetes and oral health, click HERE (https://jada.ada.org/article/S0002-8177(14)65193-X/fulltext) to read this article by The Journal of The American Dental Association.
Dental procedures should never be done when blood sugars are out of control, unless it’s an absolute emergency. Your dentist and doctor can determine when it is safe for treatment. When having any type of dental or gum procedures performed, additional measures may be appropriate such as prescribing antibiotics before and after treatment. Insulin levels may need to be adjusted as well. This reinforces how important it is for your medical team to communicate with each other.
The treatment of gum diseases varies depending on severity. Mild gum disease can be addressed by deep cleaning the teeth and infected tissue underneath the gum line. This helps to smooth out the damaged root surfaces of the teeth which allows the gum to reattach to the teeth.
When gum disease has progressed, surgery may be necessary if the gum tissue is too far gone. This requires cleaning out the infected area underneath the gum. It may be necessary to reshape or replace the supporting tissues.
Prescription rinses which help to keep your mouth moist can also be prescribed.
How to Keep Your Mouth Healthy if you have Diabetes
- Brush and floss your teeth at least twice per day
- If you smoke, stop.
- See your dentist at least twice a year.
Remember, your oral health impacts your diabetes and vice-versa. Dr. Guillory has over twenty-five years of experience and has treated thousands of patients, including those with diabetes.
Dr. Guillory and his staff at Southtown Dental care about you and your overall health and will work with your medical team to give you the best diabetic care. We treat every patient like family in a warm and caring environment and welcome you to our practice.