It is well documented that people who suffer from diabetes are more susceptible to developing infections than non-diabetes sufferers. It is not widely known that Periodontal Disease (PD) is often considered the sixth complication of diabetes; particularly when the diabetes is not under proper control.
Drs. Dennis Nishimine, Dee Nishimine, & Sophia Tseng will closely work with your medical doctor if you are diabetic or we suspect that you may be. Your periodontal examination often reveals signs and symptoms of diabetes and we may have your ruled out for diabetes with the help of your medical doctor. We will recommend that a glycosalated hemoglobin or Hb-A-1c test be provided and we would like the scores to be below 6. Periodontist often pick up diabetes before your medical doctor will because the clinical findings may indicate that diabetes is present.
If you are diabetic you can easily be treated for your periodontal condition and it in turn will have a direct effect on your diabetes in a positive manner.
Periodontal Disease (PD) (often called periodontitis and gum disease) is a progressive condition that often leads to tooth loss if treatment is not promptly sought. Periodontal Disease (PD) begins with a bacterial infection in the gingival tissue which surrounds the teeth. As the bacteria colonize, the gum pockets become deeper, the gums recede as tissue is destroyed and the periodontitis eventually attacks the underlying bone tissue.
Diabetes is characterized by too much glucose (or sugar) in the blood. Type II (Adult Onset) diabetics are unable to regulate insulin levels which means excess glucose stays in the blood. Type I (Juvenile) diabetics do not produce any insulin at all. Diabetes is a serious condition which can lead to heart disease and stroke.
Reasons for the Connection
Experts suggest the relationship between diabetes and Periodontal Disease (PD) can worsen both conditions if either condition is not properly controlled.
Here are ways in which diabetes and Periodontal Disease (PD) are linked:
Increased blood sugar – Moderate and severe Periodontal Disease (PD) elevates sugar levels in the body, increasing the amount of time the body has to function with high blood sugar. This is why diabetics with periodontitis have difficulty keeping control of their blood sugar. In addition, the higher sugar levels found in the mouth of diabetics provide food for the very bacteria that worsen periodontal infections.
Blood vessel thickening – The thickening of the blood vessels is one of the other major concerns for diabetes sufferers. The blood vessels normally serve a vital function for tissues by delivering nutrients and removing waste products. With diabetes, the blood vessels become too thick for these exchanges to occur. This means that harmful waste is left in the mouth and can weaken the resistance of gum tissue, which can lead to infection and gum disease.
Smoking – Tobacco use does a great deal of damage in the oral cavity. Not only does tobacco use slow the healing process, it also vastly increases the chances of an individual developing periodontal disease. For diabetics who smoke, the risk is exponentially greater. In fact, diabetic smokers aged 45 and over are twenty times more likely to develop advanced Periodontal Disease (PD) .
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. This is why Drs. Dennis Nishimine, Dee Nishimine, & Sophia Tseng will stress your need of daily OHI of Brushing and Flossing. We will want you to brush 4-5 times daily and floss 2 times per day.
Diagnosis and Treatment
It is of paramount importance for people suffering from any type of diabetes to see the dentist at least three to five times per year for checkups and professional cleanings. Studies have shown that simple non-surgical periodontal treatments can lower the Hb-A-1c (hemoglobin molecule blood test) count by as much as 20% in a six month period.
Drs. Dennis Nishimine, Dee Nishimine, & Sophia Tseng will use your medical history, family history and dental X-rays to assess the risk factors for Periodontal Disease (PD) and determine the exact condition of the gums, teeth and underlying jawbone. If necessary the they will work in conjunction with your medical doctors to ensure that both the diabetes and the gum disease are being managed and controlled as effectively as possible.
Non-surgical procedures performed by Drs. Dennis Nishimine, Dee Nishimine, & Sophia Tseng and dental hygienist include deep scaling, where calculus (tartar) will be removed from the teeth above and below the gumline, and root planing, where the root of the tooth is smoothed down to eliminate any remaining bacteria. Antibiotics may be applied to the gum pockets or provided orally to promote healing.
Corrective procedures or surgical procedures may be provided to correct and eliminate the infectious process and rebuild the foundation for you. Yes as a controlled diabetic with excellent OHI you will heal well. The diabetic with excellent OHI will heal as well as a non diabetic. Your two hands and your daily Brushing and Flossing are the key to success!
Before and after periodontal treatment, we will recommend proper OHI and SPT's as well as prescribing prescription mouthwashes and possibly antibiotics if indicated. If you have questions or concerns about diabetes or Periodontal Disease (PD) , please ask our Periodontal Implant Team. Contact us