Diabetes Dentistry Brisbane City
Discover the connection between diabetes and dentistry
If you have gum disease, you need to follow a treatment plan that will correct this. If you are a diabetic, you need to take very good care of your health. Good control of your blood sugar will make preventing and correcting gum disease and other complications that much easier.
At Bite Dental, we always schedule time to do a full gum measurement and check at every exam appointment — whether you’re diabetic or not. So, you can rest assured that your teeth and gums are in the best hands when you visit this Brisbane dentist.
Studies have shown that the prevalence of diabetes in Australia is increasing, with one study finding a doubling since 1981. About 4% of Australians are diagnosed with diabetes at some time in their lives (National Health Survey 2007-2008).
The Australian Diabetes, Obesity, and Lifestyle Study concluded that “Australia has a rapidly rising prevalence of diabetes. The prevalence of abnormal glucose tolerance in Australia is one of the highest yet reported from a developed nation”.
This is a huge problem for our health system as the complications of diabetes are fast becoming a dangerous burden on our hospital services. It might be hard to believe, but prevention of these complications includes adequate care of the teeth and gums.
At Bite Dental Brisbane, we treat the whole person — not just their teeth. We understand the important connections between oral health and chronic disease. That’s why, when you visit us, we take the time during our preventive visits to comprehensively review your general medical history and address your oral health as the integral part of your overall health that it is.
So, what is diabetes and why do we find it concerning?
Diabetes is a chronic condition. This means that it lasts for a long time, often for someone’s whole life.
For our bodies to work properly we need to convert glucose (sugar) from food into energy. A hormone called insulin is essential for the absorption of glucose into cells. In people with diabetes, insulin is no longer produced or not produced in sufficient amounts by the body.
So, when people with diabetes eat glucose, which is in foods such as breads, cereals, fruit and starchy vegetables, it can’t be converted into energy and absorbed. Instead, the glucose stays in the blood. This is why blood glucose levels are higher in people with diabetes — this is called hyperglycaemia.
Very simply, studies show ongoing hyperglycaemia both reduces the function of immune cells and increases inflammation. This means that people with diabetes have an immune response that doesn’t work properly and it is slow to react — leaving them more at risk to infections that their body doesn’t fight very well.
It is this process that causes the symptoms and complications of diabetes, which can be quite serious. Some of these include:
- Heart disease
- Kidney disease
- Vision and eye problems
- Painful sores on the feet and legs
- Skin and mouth infection
In more recent studies, gum disease is now considered the sixth major complication of diabetes, something which Bite Dental finds worrisome.
Download the Diabetes and Dentistry Guide
What is periodontal (gum) disease?
It’s the leading cause of tooth loss in adults and involves a deep bacterial infection of the gum that dissolves the bone around the teeth.
Over time, this erodes the grip or hold the gums have on teeth and without receiving treatment from a dentist, patients can lose their teeth.
Periodontitis (or infection around the teeth) has also been called pyorrhoea (pronounced pie-re-ah), periodontal disease, or gum disease.
Diabetes And Gum Disease
In this video, the dentists at Bite Dental, Dr Simon Franks and Dr Julia Moldavstev talk about diabetes and its link to the mouth and gum disease.
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 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 chance of diabetes, or does having diabetes increase the risk of gum disease? What we know so far indicates that it may be a feedback loop that works both ways!
A long-term study conducted at Columbia University in the United States found that individuals who had gum 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 no Brisbane dentist would recommend losing one’s teeth in an attempt to prevent diabetes, it appears that eliminating the toothy source of infection improved long-term risk.
Holistically, in a diabetic patient, the presence of any infection, including gum disease, makes it difficult to control blood glucose levels — thus making control of diabetes more difficult. Therefore, it seems that good oral hygiene and dental care to prevent infections and gum disease will also help with controlling diabetes. Yet another reason to visit your dentist regularly!
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 that will correct this. If you are a diabetic, you need to take very good care of your health. Good control of your blood sugar will make preventing and correcting gum disease and other complications that much easier.
One in every two diabetics will develop gum disease
Gum disease is a bacterial infection of the gums which can cause your teeth to fall out. Diabetics have more than three times the risk of the disease and a much higher rate of tooth loss.
What is gum disease?
Essentially, it's the dissolving of the bone around your teeth caused by an immune response to the bacteria living on and around your teeth. Once the bone is gone there is nothing we can do to grow it back again and you can end up losing your teeth.
Gum disease is irreversible, it cannot be cured
There is a genetic component to gum disease which means some people get it and some don't. As we can't change your genetics, we can't cure your risk profile for gum disease. We need to tailor a programme for you to ensure your teeth are clean enough so that your immune system doesn't react.
I'm fine — my teeth don't hurt
Gum disease is a silent, painless condition often with no real symptoms until it's too late. Why it causes no pain is a mystery. Studies have measured the ulcer size from gum disease and found it to be the equivalent area to the inside of your forearm — and yet still it produces no pain or symptoms. Patients often present only after they have noticed some movement of teeth or have a painful gum abscess. By then it is often too late to save the tooth or teeth.
Not everyone gets gum disease
It's all about your risk profile. The disease is a process that is based on your genetics and your immune response to bacteria around your teeth. If you don't have the genetics or primed immune response you may never get the disease. Diabetics experience more aggressive and severe gum disease than non-diabetics Once the infection sets in it is often very hard to control. This means it often results in tooth loss and dentures. Studies have reported up to 14% of diabetics will lose every one of their teeth from gum disease.
Only dentists can diagnose gum disease risk
The underlying problem is the bone surrounding the teeth is dissolved while the gum stays in its normal place. This means while the tooth looks normal and healthy it's just held in by the soft gums and not the bone. That's why it requires a trip to the dentist, who can measure the gums around the teeth and check the level of the bone holding the teeth in place on X-rays. This check should be done at every examination if you're a diabetic to identify any areas before they become serious.
Treatments for replacing teeth lost from gum disease can be limited
Prevention is better than cure. Due to the bone being lost, the options for tooth replacement can be restricted to plastic false teeth. Implants, crowns and bridges can be done in some situations but need to be very carefully assessed, meticulously maintained and can often require the use of bone grafts.
Early diagnosis and prevention is the key to avoiding tooth loss that results from gum disease
Once the bone has been lost, treatment options become very limited. Bone grafts can be used but carry a high risk and require extra surgery and healing times, along with costs. Often with early detection, simple changes to your home cleaning regime or changing the frequency of your professional cleaning with a hygienist can be all that's required to prevent the disease progressing.
Gum disease increases insulin resistance, making it difficult to control your diabetes
Gum disease is the same as any other infection. It will affect your glucose control and make your diabetes worse. Think of an ulcer covering most of your calf muscle and how your GP would react to this.
Treatment of gum disease is associated with an average 10% improvement in HbA1c levels
More and more studies are confirming that treatment for gum disease can improve the diabetic control of a patient.
Diabetics with active gum disease are two to three times more likely to experience cardiovascular complications and eight to nine times more at risk of renal failure. The interaction between diabetes and gum disease is a two-way street. It's a vicious circle where diabetes makes gum disease worse while gum disease makes diabetes worse. With poorer control, the incidence of diabetic complications increases. Population studies have shown for each 10% increase in HbA1c a 21% increase in diabetes-related deaths can occur.
Bite Dental Risk Assessment Program
At Bite Dental Brisbane, we understand the importance of oral health care in the overall management of diabetes. That’s why we have developed a free screening program for people diagnosed with diabetes that aims to identify existing risk factors for gum disease and tailors a preventive care plan that would best suit the patient and reduce their risk profile.
The 20-minute consult includes an OPG radiograph, random BSL, detailed medical history review and a screening examination targeted at finding gum disease in diabetics. This does not constitute the start of dental treatment or replace a routine dental examination with a dentist.
At the end of the consult, the patient will receive a short report with the details of the findings and the recommendations for preventive care that they can take to their dentist, or if they desire, we can organise appropriate referrals for treatment.
Act now before you become another statistic!
Call us today on 07 3221 5399 to arrange your complimentary gum disease risk-profile assessment.