Tag Archives: chronic disease

Diabetes and Periodontal Disease

Diabetes and periodontal disease are two common chronic diseases that are reaching epidemic proportions in America; and in fact current research indicates that the two diseases actually directly influence each other. Periodontal disease effects more than half of all adults; and according to recent statistics released by the American Diabetes Association, 25.8 million children and adults in the United States are diabetic. Another 79 million people are pre-diabetic, meaning that they are at risk for developing this serious disease which can affect many major organs including the heart, blood vessels, nerves, eyes and kidneys. Scientists understand a great deal about both diseases and they are learning more all the time… considering the number of people at risk and the potentially life threatening consequences of developing either of these conditions, isn’t it a good idea to know your risks and to understand how the two diseases are linked?

What is Diabetes?

Diabetes is a complicated disease which involves the inability of the body to make the hormone insulin (Type I) or to use the insulin that it makes (Type II). Insulin is necessary to move glucose, also known as “blood sugar” from the blood stream into the cells, to be used for energy that sustains life. When cells do not receive adequate glucose, the body stops functioning…and if too much glucose accumulates in the blood, a variety of severe health complications can occur. Furthermore, people with diabetes are at higher risk for infections and they tend not to heal as well as people without the disease because their immune systems don’t function as effectively.

Type one diabetics are born with the disease, and are treated with replacement insulin. However, type II diabetes generally develops slowly over time as insulin receptors are damaged or destroyed, thought to result from chronic inflammation. Periodontal disease is jointly caused by the by-products of oral bacteria and the body’s inflammatory response to those bacteria. The common thread appears to be inflammation, but how does the diabetes-periodontal disease relationship work? Researchers have determined that there are several reasons for the association.

  • Chronic inflammation occurs in the body for a variety of reasons including untreated periodontal infections and even excessive body fat, and the long standing inflammation causes tissue damage. This process is how the gums and bone surrounding the teeth are destroyed in periodontitis. Similarly, inflammation damages the part of the cell that allows insulin to work (the insulin receptor) making cells “insulin resistant”. As the body’s cells become increasingly resistant to insulin, type II diabetes develops. Untreated, the process continues: damaged tissue itself causes more inflammation, so one disease provokes the other.
  • High blood sugar inhibits and slows circulation. The body heals itself of infections by using specialized cells and substances transported in the blood to the site of an infection. Sluggish circulation impairs this natural healing ability, which makes the gum tissues more susceptible to infections and much more difficult to treat.
  • High glucose levels in saliva promote growth of bacteria that cause periodontal disease.
    • Untreated periodontal disease can actually increase blood sugar and make it more difficult to control; and a study in the Journal of Periodontology found that if Type II diabetes is poorly controlled, patients are more likely to develop periodontal disease.

    Many of the risk factors that are associated with Type II diabetes can be minimized through healthy lifestyle changes; and fortunately the same is true of periodontal disease. Good home care practices and regular dental checkups are the keys to good oral health, especially for people diagnosed with or at risk for diabetes. Eliminate tobacco use as well… research has shown that diabetic smokers may be 20 times more likely than diabetic non-smokers to develop periodontal disease! The major risk factors for developing Type II Diabetes include:

    • High blood pressure
    • High blood triglyceride (fat) levels
    • High-fat diet
    • High alcohol intake
    • Sedentary lifestyle
    • Obesity or being overweight

    Many people feel overwhelmed by everything they need to learn when they are first diagnosed with diabetes, but they quickly realize that they must take steps to manage their condition every day. Excellent oral care is an essential step in that process, and the good news is that your dental team understands its important role.

    Research at Columbia University has demonstrated that dentists can often identify patients with undiagnosed diabetes based on what they observe about the conditions in the mouth during a checkup. So, if you are at risk or suspect you might have the symptoms of either diabetes or periodontal disease, please take the risk seriously and speak to both your dentist and physician … it could save your life. If you have already been diagnosed with either condition then you should know that your dentist is committed to working with you and the rest of your medical team to maintain optimal health and quality of life.


    Senior Oral Health: Smiles For A Lifetime

    Like the rest of the body, our mouth and likewise our oral health needs change as we get older; and just a few generations ago, oral disease and eventual tooth loss were expected parts of the aging process. Thanks to advancements in medicine over the past fifty years, adults expect to live longer healthier lives… and when seniors and the people who care for them are aware of their unique oral health needs, it is not unrealistic to expect to keep teeth in great shape for a lifetime of smiles!

    Normal or not?

    Changes in the skin, bones, circulation and immune system that affect the body also affect the mouth; and even the teeth undergo normal changes with age. Do you know what to expect?

    A decline in the function of the immune system is a natural part of aging, but it is significant because it makes the body less capable of fighting infection. Everyone has both good and harmful bacteria in their mouth but as a result of the aging immune system, there is a gradual shift toward a greater number of the harmful bacteria which are responsible for gum disease, tooth decay and fungal infections such as yeast or thrush.

    • The Enamel: the outer shell of the tooth is the hardest substance in the body, and it is not replenished over time. Normal wear and tear over the life span causes it to be gradually worn away, which can expose the softer dentin underneath, making teeth more vulnerable to decay. Professional fluoride treatments may be recommended to strengthen the enamel. White fillings protect exposed dentin and cosmetically enhance your appearance… a stronger and more youthful smile is possible!
    • The Dentin: is the yellower, softer layer that underlies the enamel and covers the nerve of the tooth. Dentin is continually produced over the life of the tooth, and over time the tooth will naturally become darker and less sensitive to temperature. Older adults can and do have their teeth whitened with outstanding results. Usually, a cosmetic whitening procedure performed in the dental office is preferable to an over the counter product when the teeth have darkened significantly.
    • The Pulp: is the core of the tooth where the nerve and blood supply are found. The pulp shrinks as we age, making teeth less sensitive overall. Cavities may be much deeper and larger before they are felt. Many people mistakenly believe that dental checkups are less important as we get older but in reality, they are more important than ever!
    • The Bone: that supports the teeth should not change just because we get older. However, a person’s oral hygiene over their life span will directly impact the health of the bone over time. Periodontal (bone and gum) examinations are an important part of a routine dental checkup appointment for everyone. People who have had gum disease should have their bone level monitored more frequently, especially if they have difficulty fighting infections.
    • The Gums: lose collagen and connective tissue with age. Just like the skin of the rest of the body, the gums become thinner, more fragile, more susceptible to injury and infection, and may take longer to heal.

    Common problems

    Normal physiological changes may leave older adults vulnerable to oral complications… declining eyesight, failing memory and even arthritis may make self-care more challenging and those professional checkups much more critical. Chronic conditions such as diabetes, osteoporosis, and circulatory problems are often associated with aging and these can these have a major impact the health of the mouth as well. Regular checkups can alert your dentist to the possibility of underlying medical conditions that you may not be aware of; and just in case you still need to be convinced, here are some surprising facts about oral health problems commonly experienced by seniors:

    • Among those over 75 years of age, about 50% of have cavities on the roots of their teeth (root caries) and may not be aware of it. Untreated decay can progress into the pulp of the tooth causing pain and serious blood infections, such as septicemia.
    • About 25% of seniors ages 65 to 74 have severe periodontal disease. Research has linked this condition with other serious health problems such as diabetes, heart disease, stroke, respiratory illness and pneumonia in institutionalized patients.
    • Oral cancer is diagnosed most frequently in people over age 65. Each year 30,000 new cases of oral and throat cancers are diagnosed and about 8,000 individuals die from these diseases. Early cancers are treatable, but since they are usually painless they often remain undetected until they have reached the later stages. Do you know about your risk factors for oral cancer? There are many… including tobacco and alcohol use, but some oral cancers develop in people with no known risk factors at all. When was the last time you were examined by a dental professional?
    • Dry mouth is a major side effect of over 400 medications, many of which are taken by older adults. Blood pressure medications, cholesterol-lowering drugs, medicines for Alzheimer’s disease and antidepressants are just a few examples. Don’t underestimate the importance of this treatable condition… it contributes to tooth decay, gum disease, denture discomfort and it makes eating and speaking difficult or painful.

    No matter what your age, a healthy mouth is important for general health and quality of life… and many older adults are choosing to cosmetically enhance their teeth for a real self esteem boost! Your personal oral health needs might include preventive checkups, fixing or replacing teeth or a brighter and younger looking smile. Whatever the case may be, your dental team has the expertise and the products that will allow you to look your best and love your smile for a lifetime! What types of services would you be most interested in learning more about?