| Home | Our
Services | Staff | Patient
Education | Site Map |
DIABETES AND GUM DISEASE
of certain oral conditions, in particular periodontal disease, has
been reported to improve metabolic control in diabetic patients."*
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. Diabetes can cause blood vessels to thicken and become less
elastic which decreases the flow of oxygen and nutrients to body
tissues and slows the removal of harmful waste.
So if your blood sugar levels are not under control the sugar or
glucose levels in your salvia increase and feed the bacteria in your
mouth and set the stage for gum disease.
In fact, people whose diabetes is well controlled have no more
periodontal disease (infections of the gum and bone) than persons without diabetes. Children with insulin-dependent
diabetes mellitus are also at risk for gum
Thickening of blood
vessels is a complication of diabetes that may increase risk for gum
disease. Diabetes causes blood vessels to thicken, which slow the flow of
nutrients to the mouth and slows the removal of harmful wastes away from the
When diabetes is poorly
controlled, high glucose levels in mouth fluids may help germs grow and set the
stage for gum disease.
Smoking increases the
risk for gum disease. 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, bone loss and tooth loose!
Manifestations of Diabetes with undiagnosed or
poorly controlled diabetes may include:
Extensive gum disease
Poor wound healing
Pain in the tongue
Taste and salivary dysfunction
Up To Top
Treatment of periodontitis
(gum tissue) depends on how much damage the disease has caused. In the
early stages, the dentist will use deep cleaning (Scaling
and Root Planing) 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 antibiotic might also be prescribed to help control the infection.
Deep cleaning -Scaling and Root
Planing-is successful only if the patient regularly brushes and flosses to
keep the plaque from building up again.
Periodontal or gum
surgery may be needed when gum disease is very advanced and the tissues that
hold a tooth in place are destroyed. The dentist 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
If you have diabetes....
It is important for you to know how well your
diabetes is controlled and to tell your dentist this information at each
Tell them current
Frequency of low
blood sugar episodes
Medications used, dosage
When your last meal
before the appointment occurred and the type of
How often you have
glucose testing and what your latest lab and self
monitored glucose levels were.
Any changes you have
notice in your mouth since the last appointment.
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
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.
20mg Doxy BID or
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.
Up To Top
Updates on Gum Disease and Diabetes
Diabetes and Gum Disease
dentists find themselves on the front lines of a larger medical
front. Dentists are well positioned to help prevent and
combat the complications of diabetes. Treating gum disease in
diabetic patients can help them keep their diabetes under
control. Evidence of this was noted by Dr. Sebastian Ciancio
in an April 2004 Dental Practice Report article, "A conversation
with Dr. Sebastian Ciancio."
"We have data that shows if patients are diabetic and we treat
disease, their diabetes improves markedly," Dr. Ciancio
Plus, the American Diabetes Association Web site flatly states:
"Gum disease can make diabetes harder to control."
Dentists can be among the first to urge patients to get tested
for the chronic disease. As a dentist may be the first health-
care professional to suspect a patient has diabetes, dentists
can order appropriate tests or refer patients to physicians to
Up To Top
Type 2 Diabetes and Gum Disease Increases
Risk of Death by Three Times
A recent study suggest people with type 2
diabetes should be be certain they are taking excellent car of
their teeth and gums. According to a study published in
the journal Diabetes Care on the effects of periodontal disease
on mortality, people with severe periodontal disease had more
than THREE TIMES the risk of dying of cardiac or renal disease.
Johns Hopkins Medical Letter Vol. 17,
Issue 2 pg 1 April 2005
Up To Top
American Diabetic Association now defines Type 1 DM (less
common) and Type 2 DM (most common) based on the disease
etiology. These "types" are defined by impaired glucose
tolerance, impaired fasting glucose, and include gestational
the relationship between DM and periodontal disease? Numerous
studies have demonstrated that:
with more advanced systemic complications from DM usually
have a higher frequency of periodontal disease...and it
is not because these individuals have more plaque and
study after study, those with poorly controlled DM - both
Type 1 and Type 2 - have greater bone loss and more missing
teeth than well-controlled individuals.
Furthermore, uncontrolled diabetics were at risk for
progressive periodontal problems including frequent dental
infections and experienced poor healing.
The dental consequence of having DM is clear:
- make certain that your periodontal condition is treated
and well-maintained. One reason for this is that the
presence of advanced periodontal disease and dental
infections may increase insulin resistance and contribute to
a worsening of the diabetic state.
- It is possible for dental infections to become
life-threatening to an uncontrolled diabetic.
Diabetics should take heart. As their dental problems are
cared for, their glycemic control improves. As their diabetic
condition comes under control, their dental problems can more
easily be treated. It has been established that a
well-controlled diabetic experiences the same short-term
responses to periodontal therapy as non-diabetic individuals.
While procedures rendered to diabetic individuals should be of
shorter duration and less traumatic so as not to stress their
systems, well-controlled diabetics can expect to receive
"normal" care for all their dental needs, including periodontal
surgeries and dental implants
Committee on Research, Science and
Therapy of the American Academy of Periodontology. J Perio
screening for diabetes mellitus
Diabetes mellitus (DM) is
undiagnosed in approximately half of the patients
actually suffering from the disease. In addition, the
prevalence of DM is more than twice as high in
patients with periodontitis.
Thus, a high number of patients with periodontitis
may have undiagnosed DM.
During routine periodontal examination bleeding gums
is a sign of periodontitis.
This blood may be used for diabetes mellitus screening
in a dental office setting.
Up To Top
Infections May be Associated with Diabetes
to the Journal of Prosthetic Dentistry, diabetics have a increased
vulnerability to bacterial and fungal infections and an increased
risk for the development of periodontal disease, which in turn can
adversely affect control of blood sugar levels. Diabetes
Oral hygiene measures should be
initiated early to prevent the development of gum abscesses,
which are particularly susceptible to fungal invasion.**
** Journal of Prosthetic Dentistry, Vol. 86,
No 6, December 2001
Once the periodontal infection is
successfully treated, it is often easier to control blood sugar levels.
Good diabetic control is the best protection
against gum disease!
and Prevention of Gum Disease in Diabetes.
February 06, 2008
Up To Top
(information provided by the National Oral
Health Information Clearinghouse)
Improving Awareness and Dental Care of the Diabetic
patients. Dr. Gehrig and Daniels PPAD Vol 16, No.1 pg 84-87, 02/04
and Oral Disease, Ponet, Tabaj, Maglione, Melato,
Acta Diabetologica, Volume 38, Issue 2 2001 pg
**Journal of Clinical Periodontology; Volume 29 Issue 3
Page 216 - March 2002. Beikler, A. Kuczek, G. Petersilka and T. F. Flemmig
Patient Education Home Site