Diabetes and gum disease

September 23, 2011 3:15:00 PM PDT
Diabetes can result in heart disease and strokes, but many of us don't know that it can be a risk factor for a severe gum condition called periodontitis.

Periodontitis is a deep infection of the gums, close to where teeth enter the jawbone. The gums get so inflamed that they can bleed with just a touch. It's genetic and only about ten percent of Americans will get it. But if someone has diabetes, their risk for periodontitis goes way up.

Thirty-four year old Kimberly McCleese has mobile, or loose, teeth. It's most likely due to periodontitis. McCleese has diabetes which can make it worse. Her mother suffered, too.

"That's what made me go to the doctor. I remember my mother's teeth, and i didn't wan to go down the same road with my teeth falling out and getting infections in the gums," she said.

As a diabetic, Kimberly's risk of periodontal gum infections is twice that of someone without diabetes. The reverse is true as well: gum infection can raise blood sugar, and it makes the diabetes harder to control.

"If one controls periodontal disease, periodontitis, it helps the control of their diabetes," Ronald Craig, D.M.D., phD, at NYU College of Dentistry, said.

Here's what can happen in bad cases. The gum are infected in pockets deep along the teeth, and they become swollen, red, but oddly, not tender or painful.

In patients with both diabetes and periodontal disease, some dentists are more aggressive in treating the gum problem.

That can mean a thorough cleaning of the teeth, removal of the dead tissue deep in the gums, and sometimes antibiotic pills to kill the type of germ which causes the most damage. Dentists even use new forms of antibiotics that they inject into the pockets along the teeth to kill the germs directly. But mostly, daily brushing and flossing are the keys.

"It's really the patient who's the important person in this team because they need to be able to control the fresh bacteria that form every day," Craig said.

Periodontists may also want patients to schedule visits more frequently, so that they can keep the process in check with procedures in the dental chair. They may also watch the patient's blood sugar level closely. If it's under control, it means the gum infections are as well.