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Periodontal Disease and Diabetes

It is well documented that people who suffer from diabetes are more susceptible to developing infections than non-diabetes sufferers.  It is not widely known that periodontal disease is often considered the sixth complication of diabetes, particularly when the diabetes is not under proper control.

Periodontal disease (often called periodontitis and gum disease) is a progressive condition that often leads to tooth loss if treatment is not promptly sought.  Periodontal disease begins with a bacterial infection in the gingival tissue which surrounds the teeth.  As the bacteria colonize, the gum pockets become deeper, the gums recede as tissue is destroyed and the periodontitis eventually attacks the underlying bone tissue.

Diabetes is characterized by too much glucose (or sugar) in the blood.  Type II diabetics are unable to regulate insulin levels which means excess glucose stays in the blood.  Type I diabetics do not produce any insulin at all.  Diabetes is a serious condition which can lead to heart disease and stroke.

Reasons for the Connection

Experts suggest the relationship between diabetes and periodontal disease can worsen both conditions if either condition is not properly controlled.

Here are ways in which diabetes and periodontal disease are linked:

  • Increased blood sugar – Moderate and severe periodontal disease elevates sugar levels in the body, increasing the amount of time the body has to function with high blood sugar.  This is why diabetics with periodontitis have difficulty keeping control of their blood sugar.  In addition, the higher sugar levels found in the mouth of diabetics provide food for the very bacteria that worsen periodontal infections.

  • Blood vessel thickening – The thickening of the blood vessels is one of the other major concerns for diabetes sufferers.  The blood vessels normally serve a vital function for tissues by delivering nutrients and removing waste products.  With diabetes, the blood vessels become too thick for these exchanges to occur.  This means that harmful waste is left in the mouth and can weaken the resistance of gum tissue, which can lead to infection and gum disease.

  • Smoking – Tobacco use does a great deal of damage in the oral region.  Not only does tobacco use slow the healing process, it also vastly increases the chances of an individual developing periodontal disease.  For diabetics who smoke, the risk is exponentially greater.  In fact, diabetic smokers aged 45 and over are twenty times more likely to develop periodontal disease.

  • Poor oral hygiene – It is essential for diabetics to maintain excellent levels of oral health.  When daily brushing and flossing does not occur, the harmful oral bacteria can ingest the excess sugar between the teeth and colonize more freely below the gum line.  This exacerbates the metabolic problems that diabetes sufferers experience.

Diagnosis and Treatment

It is of paramount importance for people suffering from any type of diabetes to see the dentist at least twice yearly for checkups and professional cleanings.  Studies have shown that simple non-surgical periodontal treatments can lower the HbA1c (hemoglobin molecule blood test) count by as much as 20% in a six month period.

The dentist will use medical history, family history and dental X-rays to assess the risk factors for periodontal disease and determine the exact condition of the gums, teeth and underlying jawbone.  If necessary the dentist will work in conjunction with other doctors to ensure that both the diabetes and the gum disease are being managed and controlled as effectively as possible.

Non-surgical procedures performed by the dentist and dental hygienist include deep scaling, where calculus (tartar) will be removed from the teeth above and below the gumline, and root planing, where the root of the tooth is smoothed down to eliminate any remaining bacteria.  Antibiotics may be applied to the gum pockets to promote healing.

Before and after periodontal treatment, the dentist and hygienist will recommend proper home care and oral maintenance as well as prescribing prescription mouthwashes which serve to deter further bacteria colonization.

If you have questions or concerns about diabetes or periodontal disease, please contact our office.

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Testimonials

My mother is in a nursing home in Harrisville Michigan. She dropped her dentures and broke a tooth. The entire staff was in her room trying to find the broken tooth, but it must have fallen into the heat register or something. Anyway it never turned up. My brother, Rick, went to visit and called to tell me about it. "We have to do something," he told me. "I can't stand to see mom looking like this." He was planning to take a few days off and take me up north to see about getting her to the dentist to get her plate fixed. I went online and called several dentists in the area. They could not help me with the problem. Then I found Dr. Gregg Resnick DDS in Alpena. He said he could fix them and have them ready by the next day. I had our friends, Shirley and Tom Harmon, pick up the plate and take it to his office. The doctor called me (I live over 200 miles from where my mom is). Dr. Resnick was concerned that he might not be able to grind the tooth properly and that my mom wouldn't be able to chew properly. You see he was under the impression she had a full set of dentures and didn't realize that she had some lower teeth. He told me that although the tooth was broken mom would not have a problem chewing with it that way. "But, we do have a problem," I told him. "My brother can't stand to look at her with that broken tooth." He sighed and said, "Let's do it then." I could have hugged him through the phone. I promised him that if mom had a problem chewing that I would bring her handicap van and get her to his office the next day. Well, mom got her plate today. She ate dinner and said that she could chew just fine. I have Dr. Resnick to thank for this. He did me a favor and it worked out just fine. I wish there were more dentists like him. He and his staff gave me 5 star service.

Sandra C.

My name is Brad Boehm. I am a local physician in Alpena, Michigan. I had an erosion problem with my teeth that made them appear yellow and deformed. I went to see a cosmetic dentist in Atlanta, Georgia. The repair work to my teeth including veneers was over $70,000. I came home very depressed. While at a routine cleaning I discussed this with Dr. Gregg Resnick, my new dentist. He formulated a treatment plan that was identical to the plan from Georgia at less than one-third the cost. I am sure the cost in Georgia included partial rent payment for the mansion the clinic was located in.

I chose to have my teeth fixed by Dr Resnick and I truly could not be happier! During the treatment process minor adjustments were made. This required a quick end of the day visit to see Dr. Resnick instead of a day or two wasted flying to Atlanta. My family and friends comment all the time about my teeth and how I smile so much more. I would recommend Dr. Resnick to anyone who wishes to improve their smile.

Dr. Boehm

I first met Dr. Resnick 20 years ago when referred by a friend for emergency care. Now Nancy and I are thankful he has been our dentist ever since. We think of our appointments as going to an office where we will be treated as friends, not only by him, but also by the staff.

Dr. Resnick is always calm, patient, encouraging and knowledgeable in dental care. His staff reflects his demeanor. Furthermore, he is an interesting guy.

He is always interested in patients as individuals outside of the office. I remember telling him of impending surgery and later he called me at home to encourage and wish me well.

We recommend him to all our friends.

Robert and Nancy Sloan

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