Periodontal Disease

Periodontal diseases, also referred to as gum diseases, are infections of the gums and the bones that hold the teeth in the jaw. It is considered a complication of both type 1 and type 2 diabetes, as well as a very common condition for the general populace.

Diabetics of all ages are much more susceptible to infections, and also to nerve and blood vessel damage. Poorly managed diabetes can therefore lead to both moderate periodontal disease(gingivitis) and severe periodontal disease(periodontitis).

Moderate periodontal disease can result in the swelling or tenderness of the gums, bad breath and occasional bleeding when brushing the teeth. Severe cases of periodontitis can lead to the deterioration of the structures that hold the teeth in place (specifically the alveolar bone and periodontal ligament), significant bleeding, recession(loss of tissue) of the gums, surgeries and tooth extraction.

Studies have shown diabetics to be more than three times more likely than non-diabetics to develop periodontal disease. Hyperglycemia has also been shown repeatedly to increase the severity of periodontitis.

There are many risk factors for periodontal disease besides diabetes, but these are just exacerbated for diabetics. For example, stress and smoking are risk factors for developing periodontal disease, but for diabetics who are stressed and/or smoke, the risk is far greater. Furthermore, stress and smoking themselves are independent risk factors for developing type 2 diabetes.

To complicate matters further, severe cases of periodontitis in diabetics have been shown to consistently elevate blood glucose levels and increase the frequency of hyperglycemia events. This so-called “two-way relationship” between periodontitis and diabetes makes periodontitis a risk factor for further diabetes complications associated with consistently high blood glucose levels, such as peripheral neuropathy, retinopathy kidney disease and amputations.

As part of an integrated approach to managing diabetes, it is very important for diabetics to practice good oral hygiene, to consistently monitor blood glucose levels, to eat healthful whole foods and exercise daily, in order to control blood glucose and limit episodes of hyperglycemia.

Resources and Further Reading

A study showing the two-way relationship between periodontitis and diabetes: 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228943/

For a good summary about periodontal disease risk factors and diabetes: 
https://www.diabetes.co.uk/diabetes-complications/gum-disease.html

An organization devoted to periodontal disease, has comprehensive information about the different forms of periodontal disease: 
https://www.perio.org/consumer/gum-disease-and-diabetes.htm

More about symptoms and the relationship between diabetes and gum disease: 
https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=85&contentid=P00349

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