Our office is very concerned about our patients who have diabetes. These patients present a special challenge in achieving and maintaining optimum oral health due to a compromised immune system and complications caused by the destructive nature of diabetes. This can become even more of a challenge because periodontal patients often present treatment and maintenance issues due to the chronic and non-curable nature of periodontal disease.
When managing a periodontal patient with diabetes, the difficulties go up several notches due to the mutually destructive effects of these two diseases. Favorable treatment outcomes may not occur if blood sugar control is not taken into account. At Dr. Glover’s office, we have taken additional continuing education courses concentrating on treating patients who have diabetes.
Diabetes is the No. 1 systemic risk factor for periodontal disease through several mechanisms. In hyperglycemic conditions, the body’s ability to kill periodontal pathogens and repair damaged gingival tissue is severely impaired. Additionally, the inflammatory mediators responsible for periodontal destruction are elevated in hyperglycemic states. On the other hand, periodontal disease worsens blood sugar control by increasing insulin resistance, which prevents the transport of glucose from the blood vessels into the cells, resulting in high sugar concentration in the bloodstream resulting in hyperglycemia.
How is diabetes related to gingivitis, periodontal disease (gum disease) and other systemic problems? Poorly controlled individuals have a higher incidence of complications not only to periodontal disease, but also have a higher incidence of complications such as retinopathy, nephropathy, neuropathy, cardiovascular disease, stroke, infections, low birth weight babies, pancreatic cancer and cataracts. Unfortunately, the list of related complications is getting longer every day as more medical research is conducted.
When diabetic patients are well under control, the risk of periodontal disease development and progression is the same as a non-diabetic individual. However, the likelihood of a favorable treatment outcome is much lower when the patient has hyperglycemia. Successfully managing the oral contribution to blood sugar control, by preventing and aggressively treating periodontal disease, can improve the quality of life for these patients. Utilizing the various methods we have today to combat the bacteria which cause periodontal disease, we are able to help our patients get control over this debilitating disease.
Besides the different types of cleanings available, we recommend power toothbrushes, antimicrobial rinses, interdental cleaners (floss), and antibiotics. The primary reason why it is so important to prevent periodontal disease from developing in the first place, and aggressively addressing existing periodontitis In diabetic individuals, is because 65% of poorly controlled diabetics die from a heart attack of stroke.