DIABETES AND PERIODONTAL DISEASE
Epidemiological data show that diabetes is one of the main risk factors for periodontitis or periodontal disease (commonly known as periodontitis). The susceptibility to periodontitis increases by about three times in people with diabetes. Gum disease is one of the consequences of unmanaged diabetes, resulting from the breakdown of very small blood vessels (microangiopathy), similar to the breakdown in the eyes or kidneys. There is also an inverse relationship, with periodontal inflammation hurting glycaemic control and diabetes-related complications. Oral health is, therefore, an essential component of the management of this chronic disease.
WHAT IS PERIODONTAL DISEASE?
Periodontal disease is a common chronic inflammatory disease characterized by the progressive deterioration of the tooth-supporting structures (connective tissue, dental cementum, and supporting bone) and, ultimately, tooth loss. It is widespread, with more than 90% of adults in Slovenia suffering from gum disease, and a quarter of Slovenes and Slovene women suffer from periodontal disease.
Signs:
- bleeding gums that do not stop when you brush and floss,
- a change in the colour of the gums from pink to bright red,
- the formation of dental pockets and the receding of the gums from the tooth,
- yellowed and plaque-covered teeth,
- bad breath,
- manure run-off,
- swollen gums,
- tooth decay,
- gaps between teeth and the appearance of long teeth.
Causes?
Periodontal disease develops from long-standing inflammation of the gums as an advanced stage of gingivitis (inflammation of the gums). As the microbes in the plaque build-up and toxins are produced, the formation of so-called gingival pockets and strong immune system response, destruction of connective tissue and ultimately bone loss occur. As the teeth no longer have strong support in the bone mass of the jaw, they begin to fall out, leading to further complications and disease states.
DIABETES AND PERIODONTITIS - WHAT IS THE CONNECTION?
The periodontal disease used to be called the “sixth complication of diabetes”. Diabetics are more susceptible to bacterial infections (which is what periodontitis is), due to the poor functioning of their immune cells, which do not develop antibodies against pathogens associated with bacterial inflammation. Increased sugar binding to proteins and lipids and the formation of harmful molecules, altered lipid mechanisms, oxidative stress, and systemically elevated cytokine levels are factors that may contribute to the exacerbation and progression of periodontal disease.
Diabetes mellitus can be exacerbated by untreated periodontal disease, which also increases the chance of complications. Studies show that the incidence of renal impairment in diabetics who also have advanced periodontal disease is two to three times higher compared to patients without periodontal disease.
OTHER ORAL COMPLICATIONS IN DIABETICS
When blood sugar levels are elevated, the concentration of sugar in the saliva is also increased, which can lead to a dry mouth. Certain medicines for diabetics can also cause dry mouth.
The professional term for dry mouth is xerostomia which can lead to gum and tooth disease and increase the risk of viral and bacterial infections in the mouth. Saliva breaks down carbohydrates and helps fight pathogens and thus infections. A lack of saliva in the mouth causes a build-up of glucose and micro-organisms. This leads to the formation of plaque and, in the next stage, to tooth decay.
When left untreated, xerostomia can lead to infections and gum disease. High blood sugar levels combined with insufficient saliva secretion lead to an increased risk of fungal infections of the mouth and oral candidiasis. Unpleasant, sometimes white or red ulcers on the mucous membranes of the oral mucosa and changes in taste perception occur. The condition is more common in denture patients and smokers.
DIABETES AND GOOD ORAL CARE?
Treatment of periodontal disease involves a mandatory visit to the dentist or periodontist who prescribes the appropriate therapy, proper oral hygiene and regular professional teeth cleaning. In some cases, the dentist will advise antibiotics or dental surgery.
Recommended oral hygiene includes daily brushing and flossing. The golden rules for diabetics have therefore always been to visit the dentist twice a year, to change the toothbrush twice every six months, to make sure it is soft enough not to damage the gums, and to brush twice a day to keep the teeth clean.
When problems occur in the oral cavity, OROXID oral solution with active oxygen prevents and relieves irritated, bleeding and inflamed gums and oral mucosa, and speeds up recovery after damage to the gums caused by surgery.
OROXID is the only active oxygen-based oral solution registered as a medical product for the prevention and reduction of periodontal disease and the treatment of inflammation in the oral cavity. In this context, OROXID® forte oral solution and OROXID® sensitive oral solution are known.
The oxygen bubbles mechanically clean the gums and teeth in the form of a slight foaming action, even in places that cannot be reached with conventional dental instruments. The antiseptic effect of OROXID oral solution helps to target and destroy harmful microbes that are responsible for the progression of periodontal disease.
Sources:
- Preshaw, P M et al. “Periodontitis and diabetes: a two-way relationship.” Diabetologia vol. 55,1 (2012): 21-31. doi:10.1007/s00125-011-2342-y
- Rutger Persson. Diabetes and Periodontal Disease: An Update for Health Care Providers. Diabetes Spectrum 2011 Nov; 24(4): 195-198. doi.org/10.2337/diaspect.24.4.195
- Bartholomew GA, Rodu B, Bell DS. Oral candidiasis in patients with diabetes mellitus: a thorough analysis. Diabetes Care. 1987 Sep-Oct;10(5):607-12. doi: 10.2337/diacare.10.5.607.
- Skalerič E, Petelin M, Kovač-Kavčič M, Skalerič U. Periodontal treatment needs in the population of Ljubljana 20 years after the first examination. Dentist Vestn. 2008;63(2-3):63-6
WE RECOMMEND:
