Inspiration And Expert Advice: Expert Columns

Better Blood Glucose Control May Keep Gum Disease Away
The Link Between Diabetes and Gum Disease

By Charles W Martin
Founder, DDS
DentistryForDiabetics.com

Want to avoid gum disease?  One way may be to keep your diabetes well under control.  People with diabetes who keep their blood glucose levels well controlled aren’t any more likely to develop gum disease than people without diabetes.  But people with diabetes whose blood sugar isn’t controlled have a three-times-higher rate of gum disease.

I see it all the time in my practice.   The minute I look in someone’s mouth, I know something’s wrong.  I ask them about their diabetes and they’ll tell me it’s out of control.  The connection?  People who use insulin for diabetes are highly susceptible to gum disease – estimated at as much as six times higher than for people without diabetes.   

What’s scary is there’s also evidence that gum disease may contribute to higher rates of premature death in people with diabetes.  It’s thought to be a reliable predictor of higher death rates among those who have diabetes.  In addition to overall higher death rates, deaths due to specific diseases like heart or kidney disease are also higher in those who have diabetes and gum disease.  One study found that when the gums pull away from the teeth due to severe periodontal disease, bacteria can enter the bloodstream and affect the heart and kidney.

Stroke risk is also higher, due to hardening of the arteries that can happen at a much faster rate in people with diabetes and gum disease.

You may be wondering by now “How does diabetes affect susceptibility to gum disease?”   One way is by reducing the effectiveness of the body’s phagocytes, the cells that can engulf and kill other cells, like the bacteria attacking your gums.  

Another reason periodontal disease is worse in people with diabetes is the problem of reduced healing capacity. Gum disease lowers your ability to repair the tissues that are injured by the inflammation.

This is a particular problem with the periodontal ligaments, which need to be rebuilt with an influx of collagen.  Collagen makes up about 30 percent of all the proteins in the human body.  The body’s normal response to an injury in connective tissue is to send collagen to the site to repair the defect.  Because of your diabetes, your body can’t deposit enough collagen to shore up the periodontal ligament, which then continues to fail as gum disease keeps assaulting it.

Another factor that affects your dental health when you have diabetes is increased glucose levels found in the fluids in the gums.  This is known as gingival crevicular fluid or GCF.  GCF increases when you have inflammation and infection.  This increases the nutrients that feed the bacteria under the gum line around the tooth, which then multiply.   Your body increases its inflammatory response to defend against the bacteria – and unless treated the cycle continues to escalate.

If that weren’t enough, your gum tissue also has a lot of similarity to the microvascular areas of your feet, hands, retinas, and kidneys.   Gum disease can cause ulcers in your mouth.  In an oral infection that spreads through your mouth, the unseen sore created in your gums, if laid out across your hand, would cover the entire palm.   If your physician saw an injury that large on your hands, your feet or any area of your body he or she would – and should – treat it like an emergency.  Your dentist should as well.

The good news though is that gum disease can be treated and that can make a huge difference in both your oral health and your overall health.

For more information about diabetes and dental care, visit http://www.dentistryfordiabetics.com and Dr. Martin’s blog, http://www.dentistryfordiabetics.com/blog.

This article was excerpted from Dr. Martin’s new book about the two-way connections between diabetes and gum disease.

Read more about Dr. Charles Martin here.

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NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.