The Connection between Diabetes and Periodontal Disease

Posted on 07. Nov, 2012 by in Dental, Diabetes

Diabetes is becoming increasingly prevalent, and is thought to affect around 25 millionpeople in the United States. In 2007 the annual cost of medical expenses related to this condition were estimatedat around $116 billion, and another $58 billion was spent on related expenses such as inability to work and disability, and premature death. This is more than 10% of the total annual health care expenditure in the United States, and with these costs predicted to increase in the future it’s becoming more important to discover ways to help diabetics stay healthier for longer.


It’s estimated around 95% of diabetics3 will have some degree of gum disease, and around one third of these will have severe periodontal disease. Diabetics are nearly 3 times as likely to have severe periodontitis when compared to non-diabetics over the age of 45.


It’s been found that Type II diabetic patients who fail to keep their diabetes properly controlled our more likely to develop periodontal disease than diabetics who keep the disease well under control. Conversely, suffering from periodontal disease can make it more difficult for diabetics to control their blood sugar4levels. So what is the connection between these two diseases?


Diabetes is a systemic disease in that it can affect the whole body, and one of the effects of diabetes is that it can cause the blood vessels to thicken due to the inflammation created by this condition. When the blood vessels become thickened then it’s not so easy for nutrients to be transported to tissues throughout the body, and it’s more difficult for toxins and waste products to be removed.


Periodontal disease is an infection, and is created by plaque bacteria building up in the mouth. The toxins produced by the bacteria create inflammation, and as the disease worsens it causes the gums to pull away from the teeth. By this stage the immune system in a healthy person will have done its best to send extra nutrients to the affected area in an effort to try to repair the damage to the gum tissues. If someone is a diabetic this is less likely to happen due to the immune system being compromised. Periodontal disease creates open wounds in the mouth, and these are the perfect conduit for the plaque bacteria to enter the bloodstream.


Once the plaque bacteria enter the bloodstream they can travel anywhere in the body, and can cause more inflammation. This may lead to diabetics having problems controlling blood sugar levels, although the exact mechanism isn’t yet known. It’s thought the inflammation could increase insulin resistance, aggravating glycemic control. Another problem is that anyone suffering from a painful condition such as periodontal disease is less likely to feel like eating, which can make it more difficult to control blood sugar levels. Diabetics need to take more care over their oral health, and most will need to see their dentist more frequently for checkups and professional cleaning. In addition diabetics may need extra help in maintaining glycemic levels if they suffer from periodontal disease.


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A recent study found diabetics who received the proper treatment for gum disease were able to reduce their medical bills5 by around $2,500 annually. The study assessed data for diabetics with medical insurance, and assessed one group that received treatment for their periodontal disease and maintenance treatment, while the other group received treatment for periodontal disease, but either failed to complete the course of treatment or didn’t receive maintenance treatments. The study which took place over three years, found the group who received treatment and periodontal maintenance treatments went on to have lower medical bills than the group who only received initial treatment for periodontal disease.


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