Periodontal diseases are those that affect the periodontium, that is, the tissues that support the teeth. They are infectious diseases caused by bacteria, all of which can influence other factors, such as genetic or environmental factors.
They are divided into two large groups. When only the gum is affected, causing a reversible inflammation, we talk about gingivitis. However, when this inflammation is maintained for a long time and other factors are added, periodontitis, usually known (although incorrectly), begins as pyorrhea. In this case, not only inflammation occurs in the gum, but also a deeper destruction in other tissues of the periodontium – the alveolar bone, the foundation of the tooth and the periodontal ligament – forming a pocket under the gum that accumulates a large amount of bacteria and endangers the survival of the tooth.
And what are the consequences of these diseases? Its effects can be local (in the mouth) or systematic, manifesting in the rest of the body. When the condition is local, the loss of the tooth, bleeding in the gums, pain, bad breath, etc.; while in the rest of the body, when the bacteria pass into the blood, they can cause cardiovascular diseases, decompensating of diabetes and others.
Did you know that in recent years it has been proven that the relationship between diabetes and periodontitis is bidirectional? Diabetes increases the risk of suffering from periodontal diseases, and these diseases can affect diabetes by impairing glycemic control. The mechanisms that cause this directionality are complex.
HOW DOES PERIODONTITIS AFFECT DIABETES?
Periodontitis can initiate or increase the resistance of insulin, favoring the activation of the systematic immune response initiated by cytokines. We can say that periodontal diseases can influence diabetes. In a clinical study developed over two years, it was observed that the control of glycaemia in patients with type 2 diabetes with periodontal disease is worse than in those who do not have. It has also been observed that patients with periodontal disease are more at risk of suffering from this type of diabetes. Several studies conducted in patients with type 2 diabetes have concluded that periodontal treatment in these patients allows the improvement of blood glucose levels. It has also been concluded that the risk of cardiovascular mortality is three times higher in diabetics with advanced periodontitis than in diabetic patients without periodontal disease.
CONSEQUENCES OF DIABETES IN PERIODONTAL DISEASES
On the other hand, diabetes causes an inflammatory response. Diabetics are more at risk of suffering from exacerbated oral affections to bacteria and, most importantly, this disease alters the ability to resolve the infection and repair capacity, which accelerates the destruction of tissues. It has been proven that periodontal diseases are more frequent in diabetics than in patients without this pathology. It has also been shown that the risk of complications associated with diabetes (including periodontal diseases) are related to the duration of diabetes and its correct control.
A poorly controlled diabetes poses an increased risk of periodontal disease and an increased risk of alveolar bone loss. Although more frequently, diabetic patients are more at risk of suffering from other oral conditions than those who are not. The treatment of periodontal diseases is as effective in diabetic patients as in those who are not. Therefore, it is very important to make patients with diabetes aware of the importance of maintaining good oral health as part of controlling the disease.