Did you know diabetes could cause problems in your mouth? People with diabetes have a higher than normal risk of periodontal diseases, infections of the gum and bone that hold the teeth in place. In advanced stages, they lead to painful chewing problems, tooth loss and infection, making it hard to keep your blood sugar under control.

• Diabetes thickens the blood vessels, weakening the resistance of gum and bone tissue to infection.
• Many kinds of bacteria (gen-ns) thrive on sugars, including glucose. When diabetes is poorly controlled, high glucose levels in mouth fluids may help germs grow and set the stage for gum disease.
• Studies show that smokers are five times more likely than nonsmokers to have gum disease. If you are a smoker with diabetes, age 45 or older, you are 20 times more likely 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. The gums become red and swollen and may bleed during tooth brushing or flossing. This can usually be reversed with daily brushing, 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 - is an infection of the tissues that hold the teeth in place. Plaque builds and hardens under the gums pulling the gums away from the teeth and forming "pockets" of infection. This can lead to loss of the bone that holds the tooth in its socket and to tooth loss.

How Is Periodontal Disease Treated?

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. 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.

• It's important for you to know how well your diabetes is controlled and to tell your dentist 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 meal schedules or 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. Be sure to consult with your dentist or periodontist before delaying any treatment.

Source: Diabetes and Periodontal Disease, A Guide for Patients; National Institute of Dental and Craniofacial Research, NIH

Last updated June 3, 2002