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James S. Minutello, DDS &
Regina D. Minutello, DMD, MS, Inc.
Periodontics & Implant Dentistry

Diabetes

There is no known cure for diabetes mellitus, a long-term metabolic disorder due to an elevation of blood glucose levels or hyperglycemia.  Fortunately, there are measures that can control and prevent mild to severe complications as a result of it. Patients with poor diabetic control are prone to develop oral diseases such as gingivitis, periodontal disease, fungal infections, dental decay, tooth loss, enlarged parotid glands, dryness of the mouth, burning mouth syndrome, and taste dysfunction.   

 

Among all oral diseases however, periodontal disease or gum infection is the most common, major complication of diabetes.  Poorly controlled diabetics tend to have an increased incidence of gum disease and have a more rapid progression of disease.  Studies have shown that the severity of the disease is closely related to the level of control and the duration of diabetes.

 

How does being hyperglycemic affect oral health?  First, there is an increased level of glucose in the saliva and the fluid found within the space between your tooth and gum tissues which attracts bacteria to proliferate in the area and result in inflammation.  Hyperglycemia also increases the production of enzymes that degrade connective tissues, which is mainly what the supporting structures of your teeth are made of.  Uncontrolled diabetics have a more exaggerated damage to their connective tissues and delayed wound healing responses.

 

In order to decrease the bacterial load in the oral cavity, mastering an efficient, yet effective oral hygiene regimen, is a basic requirement to achieving oral health in diabetics.   Other risk factors (plaque, smoking, stress, medications, pregnancy, and hormonal changes) can exacerbate a diabetic’s periodontal status.  Unfortunately poor glycemic control is further complicated by angiopathy, retinopathy, nephropathy, neuropathy, and delayed wound healing. 

 

While it is certain that diabetes can negatively affect oral health, there has also been increasing evidence that oral infections can negatively affect diabetic control because oral inflammation can trigger insulin resistance.   Therefore periodontal infection and diabetes have a bi-directional relationship such that prevention and treatment of periodontal disease are necessary for optimal diabetic control and diabetic control is necessary for optimal periodontal/ oral health.  So just as important as achieving good oral health, blood glucose control is paramount to good overall systemic health.

http://www.perio.org/consumer/mbc.diabetes.htm

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