Dental Info for Diabetics

An estimated 17 million people in the United States have diabetes. Diabetics are more susceptible to infection and periodontal disease and the infections tend to be more severe than non-diabetic patients.

WHAT IS PERIODONTAL DISEASE?

Periodontal or gum disease is considered an autoimmune disease. It is caused by bacteria in the mouth that attaches to the tooth structures. It is true that you have many types of bacteria in your mouth that are beneficial for your body, however there are many that are not. Bacteria consume the foods that we eat and produce a soft acid waste product known as plaque. Plaque destroys the gum attachment, and the result is a deeper space between where the gum is attached onto the teeth and the gum line. This is referred to as a periodontal pocket. Periodontal pockets create a cleaning problem, because it is hard to reach into these deep areas to clean. As the bacteria continue to multiply and produce more plaque, it causes inflammation in the gums. The body’s response to inflammation is to send white blood cells to the area. The white blood cells release enzymes whose job it is to destroy bacterial cells, but they are not selective in the cells they destroy, and they end up destroying the bone that supports the teeth. It would be similar to a gunman with an Uzi who shoots indiscriminately at everything in an area, thus destroying everything in the bullets’ path.

Another problem that occurs with periodontal disease is that when the plaque stays on the teeth for even a few days, it starts to pick up the minerals in the saliva, which calcifies, and becomes known as tartar, or calculus (meaning “little stones”). The calculus is very rough and becomes firmly attached to the teeth, and become bacteria traps, since the bacteria can hide in the microscopic nooks and crannies of the calculus. Those bacteria that hide in the calculus also eat the foods we eat and produce the acid waste product, plaque. The plaque continues to cause the inflammation in the gums, the destruction of the gum attachment and pocket formation, and triggers the immune response of the white blood cells.

The detection of periodontal disease can only be performed by a dental professional by a process of measuring the distance between the gum line and gum attachment. The gum attachment should be no deeper than 3 millimetres below the gum line in a healthy mouth. Moderate periodontal disease measures 4 to 5 mm, and pockets 6 mm or deeper is considered severe periodontal disease.

To treat and arrest periodontal disease, the calculus must be thoroughly cleaned out from below the gum line. The patient will then need to disorganize the bacteria around the teeth and underneath the gum line on a daily basis. In order for the bacteria to cause damage and inflammation, they must be organized. This is their first priority. It takes them 24 hours to become organized. So when they are disorganized every 24 hours by flossing, brushing, and whatever other means the dental professional recommends, depending upon the needs of the patient, the bacteria don’t have time to do anything but try to get reorganized again, and this stops the progression of the disease. This would be like a town trying to rebuild, but every time they are almost done, a disaster occurs and wipes out all the buildings.

When the gums bleed, it is because there is an open wound under the gum line inside the lining of the pocket. When bacteria are allowed to hide in the pocket, the wound is constantly irritated and cannot heal. A blood clot forms over the wound, and when the blood clot is disturbed by flossing or brushing, the wound begins to bleed. When those bacteria are constantly disorganized on a daily basis, it allows the skin to heal over the wound, so instead of a blood clot holding the blood in the blood vessel, eventually there will be skin holding the blood in the blood vessel, and when this occurs, bleeding stops.

Medications that you take can also alter the condition of the mouth with reduced salivary flow known as (xerostomia). Xerostomia increases the risk to diabetic patients with recession and decay.

Tell Dr. Kats if you have diabetes and ask him to show you how to keep your teeth and gums healthy. Gum disease also makes it hard to control your blood sugar.

WHAT CAN I DO?