diabetes, diabets, diabetis
What is the Link Between Diabetes and Periodontal
Disease?Diabetic Control.
Like other complications of diabetes, gum disease is linked to diabetic control.
People with poor blood sugar control get 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.
Studies show that controlling
blood sugar levels lowers the risk of some complications of diabetes, such as
eye and heart disease and nerve damage. Scientists believe many complications,
including gum disease, can be prevented with good diabetic
control. Blood Vessel
Changes. Thickening of blood vessels is a complication of diabetes
that may increase risk for 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
germs grow and set the stage for gum disease.
Smoking. The harmful effects of smoking,
particularly heart disease and cancer, are well known. Studies show that smoking
also increases the chances of developing gum disease. In fact, smokers are five
times more likely than nonsmokers to have gum disease. For smokers with
diabetes, the risk is even greater. If you are a smoker with diabetes, age 45 or
older, you are 20 times more likely than a person without these risk factors to
get severe gum disease.
How Does Periodontal Disease
Develop?Gingivitis. Poor
brushing and flossing habits allow dental plaque -- a sticky film of germs -- to
build up on teeth. Some of these germs cause gum disease. The gums can become
red and swollen and may bleed during toothbrushing or flossing. This is called
gingivitis, the first stage of periodontal disease.
Gingivitis can usually be reversed with daily brushing and flossing and
regular cleanings by the dentist. If it is not stopped, gingivitis could lead to
a more serious type of gum disease called periodontitis.
Periodontitis. Periodontitis is an
infection of the tissues that hold the teeth in place. In periodontitis, plaque
builds and hardens under the gums. The gums pull away from the teeth, forming
"pockets" of infection. The infection leads to loss of the bone that holds the
tooth in its socket and might lead to tooth loss.
There are often no warning signs of early periodontitis. Pain, abscess, and
loosening of the teeth do not occur until the disease is advanced. Since
periodontitis affects more than just the gums, it cannot be controlled with
regular brushing and flossing. Periodontitis should be treated by a periodontist
(a gum disease specialist) or by a general dentist who has special training in
treating gum diseases.
How Is Periodontal Disease
Treated?Plaque Removal.
Treatment of periodontitis depends on how much damage the disease has caused. In
the early stages, the dentist or periodontist will use deep cleaning to remove
hardened plaque and infected tissue under the gum and smooth the damaged root
surfaces of teeth. This allows the gum to re-attach to the teeth. A special
mouthrinse or an antibiotic might also be prescribed to help control the
infection.
Deep cleaning is successful only
if the patient regularly brushes and flosses to keep the plaque from building
up again. Periodontal
Surgery. Gum surgery is needed when periodontitis is very advanced
and tissues that hold a tooth in place are destroyed. The dentist or
periodontist will clean out the infected area under the gum, then reshape or
replace the damaged tooth-supporting tissues. These treatments increase the
chances of saving the tooth.
If You Have Diabetes...
It's important for you to know how well your diabetes is controlled and to
tell your dentist this information at each visit.
See your doctor before scheduling treatment for periodontal disease. Ask
your doctor to talk to the dentist or 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 dentist'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.
Are Other Oral Problems Linked to
Diabetes?Dental Cavities.
Young people with IDDM have no more tooth decay than do nondiabetic children. In
fact, youngsters with IDDM who are careful about their diet and take good care
of their teeth often have fewer cavities than other children because they don't
eat many foods that contain sugar.
Thrush. Thrush is an infection caused by a
fungus that grows in the mouth. People with diabetes are at risk for thrush
because the fungus thrives on high glucose levels in saliva. Smoking and wearing
dentures (especially when they are worn constantly) can also lead to fungal
infection. Medication is available to treat this infection. Good diabetic
control, no smoking, and removing and cleaning dentures daily can help prevent
thrush.
Dry Mouth. Dry mouth is often a symptom of
undetected diabetes and can cause more than just an uncomfortable feeling in
your mouth. Dry mouth can cause soreness, ulcers, infections, and tooth decay.
The dryness means that you don't have enough saliva, the mouth's natural
protective fluid. Saliva helps control the growth of germs that cause tooth
decay and other oral infections. Saliva washes away sticky foods that help form
plaque and strengthens teeth with minerals.
One of the major causes of dry mouth is medication. More than 400
over-the-counter and prescription drugs, including medicines for colds, high
blood pressure or depression, can cause dry mouth. If you are taking
medications, tell your doctor or dentist if your mouth feels dry. You may be
able to try a different drug or use an "artificial saliva" to keep your mouth
moist.
Good blood glucose control can
help prevent or relieve dry mouth caused by
diabetes. Keep Your
Teeth
Serious periodontal disease not only can cause tooth loss, but can also cause
changes in the shape of bone and gum tissue. The gum becomes uneven, and
dentures may not fit well. People with diabetes often have sore gums from
dentures.
If chewing with dentures is painful, you might choose foods that are easier
to chew but not right for your diet. Eating the wrong foods can upset blood
sugar control. The best way to avoid these problems is to keep your natural
teeth and gums healthy.
How Can You Protect Your Teeth and
Gums?Harmful germs attack the teeth and gums when plaque
builds up. You can stop plaque build-up and prevent gum disease by brushing and
flossing carefully every day.
- Use a piece of dental floss about 18 inches long.
- Using a sawing motion, gently bring the floss through the tight spaces
between the teeth.
- Do not snap the floss against the gums.
- Curve the floss around each tooth and gently scrape from below the gum to
the top of the tooth several times.
- Rinse your mouth after flossing.
- Gently brush teeth twice a day with a soft nylon brush with rounded ends
on the bristles.
- Avoid hard back-and-forth scrubbing.
- Use small circle motions and short back-and-forth motions.
- Gently brush your tongue, which can trap germs.
- Use a fluoride toothpaste to protect teeth from decay.
Check Your Work. Dental plaque is hard to see unless it
is stained. Plaque can be stained by chewing red "disclosing tablets" sold at
grocery stores and drug stores or by using a cotton swab to smear green food
coloring on the teeth. The color left on the teeth shows where there is still
plaque. Extra flossing and brushing will remove this plaque.
Dental Check-ups. People with diabetes
should have dental check-ups at least every 6 months, or more often if
recommended by their dentist. Be sure to tell your dentist you have diabetes.
Frequent dental check-ups are needed to find problems early when treatment is
most effective. See your dentist as soon as possible if you have any problem
with your teeth or mouth.
Keeping on Top of Your Condition
Keeping in tune with your disease or condition not only makes treatment less intimidating but also increases its chance of success, and has been shown to lower a patients risk of complications. As well, as an informed patient, you are better able to discuss your condition and treatment options with your physician.
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