Peggy Stoor, RDH
Periodontal Disease and Diabetes
Recently much has come to light regarding oral health and its impact on systemic health and disease. While I’ve always been borderline fanatic about oral health and have been aware of some of these relationships, the recent research connecting oral health to systemic health has helped to make my daily work much more relevant and interesting.
Presently there are 18 million diabetic patients in the U.S. and 171 million diabetic patients worldwide. Diabetes is characterized by increased susceptibility to infection, poor wound healing, and a number of complications that can affect quality of life and length of life. Diabetes is also a risk factor for severe periodontal disease (the destruction of tissues and bone that support the teeth). It’s critically important to realize that diabetics who have periodontal or gum disease have two chronic conditions, each of which affect the other.
While we have long known that diabetes can predispose one to periodontal disease, research now suggests that treatment of periodontal disease can have a positive impact on the diabetic condition. Patients with periodontal disease have more difficulty controlling their blood sugar. Patients who have treatment and gain control of their gum disease have been shown to require less insulin and have a decreased hemoglobin A1c level. (A1c denotes a patients average blood sugar level over the past 3 months). In other words, periodontal disease and diabetes is a two-way street with each disease having a potential impact on the other, either positively or negatively.
Management of gum disease in patients with diabetes involves removal of plaque and calculus both at home and professionally, and maintenance of glycemic control. Nearly all diabetics respond to treatment and maintenance, therefore treatment of periodontal disease should be done as soon as possible. Both conditions require frequent professional evaluations, patient-self monitoring, daily brushing and flossing, approved antibacterial mouth rinses, and good blood glucose control.
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Southerland, J.H. (2005.) Diabetes and periodontal infection: Making the connection. Retrieved from http://clincial.diabetesjournals.org/content/23/4/171
Diabetes and Periodontal Disease: Retrieved from http://www.perio.org, American Academy of Periodontology, Diabetes and periodontal Disease
Diabetes and Oral Health: Retrieved from http://www.nidcr.nih.gov/OralHealth/Topics/Diabetes.National Institute of Dental and Craniofacial Research by National Institutes of Health-(2007)
Mealey, B.L. ,(2006).Periodontal disease and diabetes: A two-way street. Journal of American Dental Association. Oct.137 suppl:26S-31S. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed
Mirza,B.A., Syed A., Izhar F., Ali Khan. (2001). Bidirectional relationship between diabetes and periodontal disease: Review of evidence. J Pak Med Assoc. Retrieved from http: http://www.ncbi.nlm.nih.gov/pubmed/21381588
Dental Care and Diabetes. http://www.webmed.com/diabetes/dental-health-dental-care-diabetes