Diabetes mellitus (DM) is a condition that results in prolonged elevated blood sugar levels throughout the body. Normally, our pancreas produces a hormone, insulin, to remove sugar from blood when we eat. In Type I DM, the pancreas does not produce enough insulin. Type II DM results from insulin-resistance, where the body does not respond properly to insulin production. Both types lead to persistent, dangerously high levels of blood sugar that negatively affect all tissues in the body, including those that support teeth.
Symptoms of Uncontrolled Diabetes in the Mouth
If blood levels are managed properly, there should be no complications of DM. However, high blood sugar has detrimental effects on normal immune functionality. Everyone has bacteria living in their mouth. With the presence of a chronic inflammatory disease, such as DM, it becomes harder to keep these bacteria in check. Consequently, gums tend to become enlarged and inflamed, a condition called gingivitis. If left untreated, this can lead to irreversible bone loss, or periodontitis. In fact, periodontitis is the most common dental disease present in those struggling with DM management.
A Bidirectional Relationship
What’s more interesting is that research suggests the relationship between diabetes and gum disease is bidirectional. In other words, elevated blood sugar makes people more susceptible to gum disease AND gum disease, like most inflammatory conditions, may increase blood sugar. This makes DM even harder to control. That is why it is essential to not only manage blood sugar levels, but to practice proper oral hygiene.
What Can You Do?
- Have regular check-ups
- Ask your dentist about more frequent recall appointments
- Brush and floss at least twice a day
- Have a healthy, balanced diabetic diet
- Do not smoke
- Clean dentures frequently
Botero, J.E.; Rodriguez, C.; Agudelo-Suarez, A.A. “Periodontal treatment and glycaemic control in patients with diabetes and periodontitis: an umbrella review.” Australian Dental Journal . 61:2, 134-148. 2016.
Firatli, Erhan. “The Relationship Between Clinical Periodontal Status and Insulin-Dependent Diabetes Mellitus. Results After 5 Years.” Journal of Periodontology. 68:2, 136-140. 1997.
Kidambi, Srividya and Patel, Shailendra. “Diabetes Mellitus: Considerations for Dentistry.” The Journal of the American Dental Association. 139:5, 8S-18S. 2008.
Martin, Laura. “Diabetes and your Smile.” Mouth Healthy. American Dental Association, 2016. <http://www.mouthhealthy.org/en/az-topics/d/diabetes>.
Miller, S.M.; Manwell, M.A.; Newbold, D.; Reding, M.E.; Rasheed, A.; Blodgett, J.; Komman, K.S. “The Relationship Between Reduction in Periodontal Inflammation and Diabetes Control: A Report of 9 Cases.” Journal of Periodontology. 63:10, 843-848. 1992.