Diabetes and Gum Disease – What You Should Know
Here at Bite Dental, we aim to provide a warm, welcoming, and fun atmosphere for our patients – whom we call our friends! But that does not mean we can’t take your health and well-being at all levels seriously. That includes connecting the dots between oral health needs and other health issues. So let’s be serious for a moment, and talk about the growing evidence for the link between gum disease and diabetes.
What is Diabetes?
Diabetes is a metabolic disorder in which the body fails to produce adequate amounts of the hormone insulin. Since insulin is necessary for the absorption of glucose, this condition leads to abnormally high concentrations of blood sugar. This in turn causes symptoms such as increased thirst and urination, extreme hunger, and fatigue. Careful treatment is necessary to prevent the advanced symptoms and complications of diabetes, which can be quite serious. These include obesity, heart disease, kidney disease, vision and eye problems, painful sores and nerves in the feet and legs, and skin and mouth infections.
Studies have shown that the prevalence of diabetes in Australia is increasing, with one study finding a doubling since 1981. According to a National Health Survey (2007-2008), about 4% of Australians have been diagnosed with diabetes at some time in their lives. This proportion holds true for all states and territories, and is similar for major cities, regional areas, and remote areas. The prevalence of diabetes increases with age: another study sampled Australians over 25, and found a 7% rate of the disease. In both studies, men were somewhat more likely than women to be diagnosed with diabetes.
This has led the authors of the Australian Diabetes, Obesity, and Lifestyle Study to conclude that ‘Australia has a rapidly rising prevalence of diabetes and other tags of abnormal glucose tolerance. The prevalence of abnormal glucose tolerance in Australia is one of the highest yet reported from a developed nation with a predominantly European background’.
So Where Does Gum Disease Fit In?
This is a true chicken-and-egg question. More and more, evidence shows that people with periodontal disease (that’s the fancy name for ‘gum disease‘) are more likely to be diabetics than people with healthy gums. But, researchers still aren’t sure which comes first – does having diseased gums increase the chances of developing diabetes, or does having diabetes increase the risk of periodontal disease? What we do know so far indicates that it may be a feedback loop that works both ways!
In a long-term study conducted at Columbia University in the United States, researchers followed 9,000 people who did not have diabetes. Over the 20-year study period, those individuals who had periodontal disease were more than twice as likely to develop diabetes as those who did not – even after adjusting for age, smoking, diet, and so on. An interesting twist however, was that those subjects whose gum disease progressed to the point where they lost all of their teeth appeared to be at a lower risk for diabetes! While we don’t recommend losing one’s teeth in an attempt to prevent diabetes, it appears that eliminating the toothy source of infection improved long-term risk. Extending this idea, it seems that good oral hygiene and dental care to prevent infections and gum disease may also lower the risk of contracting diabetes.
One explanation for this is that periodontal disease affects the body’s metabolism in ways that make it more difficult to control blood sugar. Having serious gum infections is known to increase blood sugar, putting diabetics at risk for complications. In a 1997 study conducted among Pima Indians of the southwestern US, those subjects who had both diabetes and gum disease showed a noted improvement in blood sugar management once their periodontal infections were treated.
Diabetic With No Gum Disease – Yet
If you’re a diabetic but think your gums are fine – sorry, you’re not off the hook. People with diabetes are known to be at higher risk for developing periodontal disease that non-diabetes. Ongoing research has turned up several possible explanations for this:
- Diabetics are more susceptible to infections of all kinds, because their immune system does not always function properly.
- Wound healing doesn’t take place as effectively in diabetics, so wounds to the gums take longer to heal.
- Diabetes affects the small blood vessels known as capillaries, which can restrict blood flow to various parts of the body, including the gums. This impairs healing and allows infection to spread.
- Diabetes affects weight control, so diabetics can have a tendency toward obesity. The excess body fat in obese people may produce chemicals that increase inflammation in the gums.
What It Means For You
In practical terms, it really doesn’t matter whether the chicken came first, or the egg. If you have gum disease, you need to follow a treatment plan will correct this. If you are a diabetic, you need to take very good care of your health – including managing your blood sugar levels as instructed by your physician. Controlling your blood sugar will make preventing and correcting gum disease that much easier.
You need to take very good care of your gums! Here at Bite Dental, we always schedule the time to do full gum measurement and check at every exam. Follow your recommended exam and cleaning schedule, and practice good self-care with daily brushing and flossing. Our team can help by giving you instructions on how to properly care for your teeth and gums at home.
Your bonus: a smile that brightens up the day, every day!