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.
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