Diabetes, Blood Glucose and Gum Disease

Health Professional

A Two-way Relationship. Many patients with diabetes might have trouble managing their blood glucose. For many, the problem is that for some unknown reason their blood glucose levels seem to bounce all over the place with little rhyme or reason. There could be several reasons for this problem, and one of the least known "silent" problems is chronic gum or periodontal disease, one of the most serious dental conditions for patients with diabetes.

For patients with diabetes, gum disease will alter your blood glucose readings. How much it will affect your glycemic control is subject to many other variables. Some of those variables revolve around the influence of other diabetes complications such as musculoskeletal problems in your hands, nerve problems, thyroid, bone, nutritional deficiencies, and psychosocial issues, to name a few.

It is estimated that one-third of diabetes patients suffer from gum disease_._ Research has demonstrated that a two-way relationship exists between blood sugar levels (or glycemic control) and gum disease. Prevention of gum disease is key to minimizing the impact of this disease on your glycemic control.** What is gum disease?** It is due to the presence of plaque (bacteria accumulation) or calculus (plaque will harden after 2-3 days) accumulating on your teeth at the gumline. The chronic persistence of this plaque and calculus leads to an infection of the tissues supporting your teeth.

Your gum tissue is not attached to the teeth as high as it may seem. There is a very shallow crevice called a sulcus between the tooth and gums. This goes around the total circumference of the tooth. Periodontal diseases attack just below the gum line in the sulcus, where they may cause the attachment of the tooth and its supporting tissues to be destroyed. As the tissues are damaged, the sulcus develops into a "pocket": generally, the more severe the disease, the greater the depth of the pocket.

Left unchecked, the tooth loses all bone support and will be lost.

There is also a relationship between edentulous (no teeth) individuals and the incidence of nutrition disorders, obesity, and diabetes. It's important to realize that this leading cause of tooth loss in adults can be prevented.


What are the stages of gum disease?** The two major stages are** gingivitis** and** periodontitis**. Gingivitis is a** milder and reversible** form of periodontal disease that only affects the gums. Gingivitis may lead to more serious, destructive forms of periodontal disease called
periodontitis. To prevent these problems, an individual must be able to engage in dental self-care. The goals and tools to achieve adequate dental self-care to prevent the development of dental diseases are provided by dental professionals. As self-care can be a problem for persons with diabetes, they are more prone to developing **

Photo of gum disease

** gum disease. Treatment of gum disease can vary depending on the severity but it can be stopped. Independent of diabetes, periodontal disease has been found to have incidental relationships with coronary artery disease, stroke, and low-birth weight infants.

Some factors increase the risf developing periodontal disease:

  • Tobacco smoking or chewing
  • Systemic diseases such as diabetes
  • Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives
  • Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives
  • Bridges that no longer fit properly
  • Crooked teeth
  • Fillings that have become defective
  • Pregnancy or use of oral contraceptives
  • Physical disability or impairments

Several warning signs that can signal a problem:

  • Gums that bleed easily
  • Red, swollen, tender gums
  • Gums that have pulled away from the teeth
  • Persistent bad breath or bad taste
  • Permanent teeth that are loose or separating
  • Any change in the way your teeth fit together when you bite
  • Any change in the fit of partial dentures

How can you prevent or stop this from happening? It is possible to have periodontal disease and have no warning signs. This is why regular dental checkups, including a periodontal examination, are very important. Brushing and flossing are the only way to effectively remove plaque and debris from your teeth. Treatment methods are dependent upon the type and severity of the gum disease. While there are many different types of toothbrushes, your dental team will will recommend dental devices and dental aids that will help you achieve optimal oral health. Generally, "trial and error" is used to determine what dental devices work for patients. Ultimately, you must perform these tasks as prescribed.

Bugs beware! Good oral hygiene is essential to prevent periodontal disease from occurring. You don't have to lose teeth to periodontal disease. Brush and clean between your teeth, eat a balanced diet, and schedule regular dental visits to ensure optimal oral health. For persons with diabetes, optimal oral health can be only achieved with excellent control of your diabetes.

How are you about brushing and flossing?

I look forward to your comments!