Some common medical conditions and dental problems. Part 1: Diabetes
In the blogs so far, I have written a lot about the complex nature of dental diseases and the many different factors which can cause or be associated with these diseases. Some of these factors are intrinsic and come from ‘inside’ us- our overall health, our genetic make up, our age…while others are extrinsic and environmental- our stress levels, our habits (oral hygiene habits, smoking, illicit drug use), our diet…
This article series summarizes some ways in which medical conditions affect our dental health.
You must be aware, though, that just because you may have one of these conditions you don’t necessarily have to suffer from poor oral health, but you are definitely at a much higher risk of developing dental problems and must take your preventative dental care seriously.
Periodontal disease is a chronic inflammatory condition of the periodontal tissues (gums, ligaments, bone, which support our teeth). It usually begins with a reversible inflammation of the gums (gingivitis). In susceptible individuals, the bacteria spread to below the gums, where they cause gum pocketing (gums loosen up around the necks of teeth and create small pockets where bacteria can settle). Bacteria in the gum pockets mutate into nastier types than their cousins on the surface and can then cause more severe damage to the deeper tissues, such as ligament and bone around the tooth, causing the tooth to loosen or even creating abscesses around otherwise healthy teeth. Severe periodontal disease leads to tooth loss and also subsequently affects any implant replacement of lost teeth.
It has been well documented that periodontal disease is one of the most common complications of Type II Diabetes (diabetes). Patients with diabetes are more likely to suffer from periodontal disease, their periodontal disease advances much faster and they also suffer from much more severe forms of periodontal disease than non-diabetics. Both these diseases are very common and they also seem to affect the same age group (35-65).
Type II Diabetes is a disease with a very high incidence: statistics show that more than 7 per cent of US population have diabetes, while it also affects 4% of Australians and 12.8% of Indigenous Australians. It accounts for 90% of all diabetes cases and is primarily caused by obesity.
Type II Diabetes is a result of high blood glucose levels due to insulin resistance (insensitivity) and one of the triggers of such resistance is chronic disease.
We used to think of periodontal disease as a localized infection and inflammation of the gums and supporting structures around our teeth. However, this disease also has some more far-reaching consequences to our health. People who suffer from severe periodontal disease show increased levels of chemicals in their blood which regulate inflammation elsewhere in the body. Diabetics also have inflammatory messengers elevated in their blood, which is makes them insensitive to insulin.
When periodontal disease and diabetes come together, the presence of these messengers is so high that it makes it very difficult to control diabetes and makes the sufferer even more insensitive to insulin.
While the relationship between periodontal disease and diabetes is not a causative one (we can’t say that periodontal disease causes diabetes or vice versa), the presence of periodontal disease in a diabetic makes this person more sick. This is also true in the opposite direction: diabetes makes periodontal disease more aggressive.
What can you do to protect your teeth and your health?
If you suffer from diabetes, you MUST find a good dentist and a hygienist and establish a strong relationship with them. Be serious about your preventative dental care and commit to 3-4 monthly cleaning of your teeth and gums (three to four times per year). Most healthy people can get away with 6 monthly preventative visits, but your medical status makes you much more vulnerable to aggressive, destructive periodontal disease which can develop very quickly if your diabetes becomes poorly controlled or your hygiene habits change.
It has been proven that poorly controlled diabetes improves after non-surgical periodontal treatment (the sort of treatment your hygienist, dentist or periodontist can provide for your routinely).
By increasing the frequency of your preventative care visits and professional cleans, you are not only protecting your teeth and gums, you are also improving your overall health!
If you are unsure whether you may suffer from diabetes, please visit your medical GP as soon as possible. If you are a sufferer, visit http://www.diabetesaustralia.com.au for most up to date information and support.
If you need to talk to a dentist regarding your oral health, which may have been affected by your diabetes, call The Dentist at 70 Pitt Street on (02) 92326367 or email us on info@thedentist.net.au.
