Elevated Blood Sugar and Gum Disease

Gum Disease and Diabetes

People with diabetes are more likely to have periodontal (gum) disease than people without diabetes, probably because diabetics are more susceptible to contracting infections. In fact, periodontal disease is often considered the sixth complication of diabetes. Those people who do not have their diabetes (or blood sugar level) under control are especially at risk.

A study in the Journal of Periodontology found that poorly controlled type 2 diabetic patients are more likely to develop periodontal disease than well-controlled diabetics.

Research has emerged that suggests that the relationship between periodontal disease and diabetes goes both ways - periodontal disease may make it more difficult for people who have diabetes to control their blood sugar, and people who have uncontrolled diabetes and uncontrolled blood sugar level may be more prone to having periodontal disease.

Severe periodontal disease can increase blood sugar, contributing to increased periods of time when the body functions with a high blood sugar level. This puts diabetics at increased risk for diabetic complications. Thus, 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 when their periodontal infections were treated, the management of their diabetes was markedly improved.

The above information has been provided by the American Academy of Periodontology (AAP).  The AAP is the professional organization for periodontists - specialists in the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants.  Periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

Additional Facts about Diabetes and Periodontal Disease

Diabetic Control - Like other complications of diabetes, periodontal (gum) disease is linked to diabetic control. People with poor blood sugar control get periodontal (gum) disease more often and more severely, and they lose more teeth than do persons with good control. In fact, people whose diabetes is well controlled have no more periodontal disease than persons without diabetes. Children with IDDM (insulin-dependent diabetes mellitus) are also at risk for gum problems. Good diabetic control is the best protection against periodontal disease.

Blood Vessel Changes -Thickening of blood vessels is a complication of diabetes that may increase risk for periodontal (gum) disease. Blood vessels deliver oxygen and nourishment to body tissues, including the mouth, and carry away the tissues' waste products. Diabetes causes blood vessels to thicken, which slows the flow of nutrients and the removal of harmful wastes. This can weaken the resistance of gum and bone tissue to infection.

Bacteria - Many kinds of bacteria (germs) thrive on sugars, including glucose -- the sugar linked to diabetes. When diabetes is poorly controlled, high glucose levels in mouth fluids may help bacteria (germs) grow and set the stage for gum disease.

If You Have Diabetes...

• It's important for you to know how well your diabetes is controlled and to tell your dentist / periodontist this information at each visit.
• See your doctor before scheduling treatment for periodontal disease. Ask your doctor to talk to the dentist / periodontist about your overall medical condition before treatment begins.
• You may need to change your meal schedule and the timing and dosage of your insulin if oral surgery is planned.
• Postpone non-emergency dental procedures if your blood sugar is not in good control. However, acute infections, such as abscesses, should be treated right away.

For the person with controlled diabetes, periodontal or oral surgery can usually be done in the periodontist's office. Because of diabetes, healing may take more time. But with good medical and dental care, problems after surgery are no more likely than for someone without diabetes.

Once the periodontal infection is successfully treated, it is often easier to control blood sugar levels.

Dental Check-ups - People with diabetes should have dental check-ups at least every 6 months, or more often if recommended by their periodontist or dentist. Be sure to tell your periodontist and dentist you have diabetes. Frequent dental check-ups are needed to find problems early when treatment is most effective. See your periodontist or dentist as soon as possible if you have any problems with your teeth or mouth.

Preventing or controlling periodontal (gum) disease is a matter of teamwork. The best defense against this complication of diabetes is good blood sugar control, combined with adequate daily brushing and flossing and regular dental check-ups.