Diabetes and Gum Disease

By Catherine M. Fascilla, D.D.S.

Diabetes is a condition that affects the body’s ability to use blood sugar (glucose) for energy. When we eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into the cells where it is used for growth and energy. In people with diabetes, the pancreas either produces little or no insulin or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood and overflows into the urine. Thus the body loses its main source of fuel even though the blood contains large amounts of sugar.

Periodontal disease is the scientific name used to describe gum disease. The periodontium is the tissue that supports the teeth. The two forms of gum disease are gingivitis and periodontitis. Gingivitis is a mild inflammation of the gums. Periodontitis is more serious. It is severe inflammation of the gums that causes the bone holding the teeth in place to be destroyed.

People with diabetes are more likely to have periodontal disease than people without diabetes. Research is currently ongoing to understand why. It is probably because diabetics are more susceptible to contracting infections. Their immune system may not function properly. Diabetics generally have poor wound healing. Also, excess lipid tissue (body fat) in obese people with diabetes may produce chemicals that are more likely to increase inflammation. Damage to capillaries (small delicate blood vessels) in the gums may reduce the blood supply to the gums and limit the action of defense cells. Periodontal disease is often considered the sixth complication of diabetes. Those who don’t have their diabetes under control are especially at risk.

Recent research suggests that the relationship between gum disease and diabetes goes both ways. Severe periodontal disease can increase blood sugar. A study in the Journal of Periodontology in 1997 involving 113 Pima Indians with both diabetes and periodontal disease found that when their periodontal infections were treated, the management of their diabetes markedly improved.

In summary, it is very important for all people with diabetes to visit a dentist regularly especially if their diabetes is poorly controlled.

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