Whole Body Health - Oral Health and Diabetes

Individuals living with type 1 and type 2 diabetes are used to managing multiple health conditions. With a constant focus on blood glucose levels it may not be all that surprising that good oral hygiene should be of importance to all diabetics.

It may be more surprising however to learn that patients with diabetes have an 86% increased risk of the progression of gum disease (otherwise known as periodontal disease) compared to non-diabetics.1 The rate of periodontal destruction in diabetics is directly correlated to lack of glycemic control as measured by hemoglobin a1c levels – consistently having hemoglobin a1c over 7.0 results in an increased risk for periodontal destruction.

Undisturbed plaque can lead to Gingivitis (inflammation) which if left untreated can lead to the development of Periodontitis. Experts have discovered an interesting two-way relationship between diabetes and periodontitis.

Diabetics have a higher risk for developing periodontal diseases (gingivitis and severe periodontitis).^4,5A number of factors are associated with increasing insulin resistance in diabetic patients.

The presence of periodontitis can increase the risk of diabetes.^4,5

- Acute bacterial / viral infections

- Chronic low-grade inflammation

- Peridontal bacteria 5,6,7

Insulin resistance results in:

- Increased insulin production

- Increased hunger

- Higher blood pressure and weight gain

- Overall increase in diabetes risk 8

What are the main warning signs diabetic patients should look out for?

Gingivitis

- Red, swollen or tender gums

- Bleeding gums

- Persistent bad breath

Periodontitis

- Receding gums

- Loose teeth

- Sensitive teeth

- Pain when chewing

- Prolonged healing of wounds from dental treatments

Due to the risk of progressive peridontal disease maintaining good oral hygiene is important in patients with diabetes.

Speak to your dental professional about the best way to keep your mouth healthy.

References

1. Nascimento GG, Leite FRM, Vestergaard P, Scheutz F, Lopez R. Does diabetes increase the risk of periodontitis? A systematic review and meta-regression analysis of longitudinal prospective studies. Acta Diabetol 2018; 55(7):653-667.

2. Lalla E, Chen B, Lal S, Kaplan S, Softness B, Greemberg E, Goland RS, Lamster IB. Diabetes-related parameters and periodontal conditions in children. J Periodontal Res 2007; 42:345-349.

3. Grossi SG, Genco RJ. Periodontal disease and diabetes mellitus: A two-way relationship. Ann Periodontol 1998; 3:51-61.

4. Preshaw PM, Alba AL, Jepsen S, Konstantinidis A, Makrilakis K, Taylor R. Periodontitis and diabetes: A two-way relationship. Diabetologia 2012; 55:21-31.

5. Lalla E, Chen B, Lal S, Kaplan S, Softness B, Greemberg E, Goland RS, Lamster IB. Diabetes-related parameters and periodontal conditions in children. J Periodontal Res 2007; 42:345-349.

6. Foley NC, Affoo RH, Siqueira WL, Martin RE. A systematic review examining the oral health status of persons with dementia. JDR Clinical & Translational Research 2017; 2:330342

7. Fernadez-Real JM, Lopez-Bermejo A, Vendrell J, Ferri MJ, Recasens M, Ricart W. Burden of infection and insulin resistance in healthy middle-aged men. Diabetes Care 2006; 33:421-427.

8. Sugiyama S, Takahashi SS, Tokutomi FA, Yoshida A. Kobayashi A, Yoshino F, et al. Gingival vascular functions are altered in type 2 diabetes mellitus model and/or periodontitis model. J Clin Biochem Nutr 2012; 51:108-113.