The relationship between diabetes and periodontal disease is bi-directional: the hyperglycemia of diabetes contributes to produce an inflammatory hyper-response to oral biofilm (bacterial dental plaque) and compromises tissue repair, which leads to an increase in periodontal destruction.
The treatment of periodontitis improves the control of diabetes. Not treating periodontal infections can also affect the general health of patients with diabetes and, for example, increase insulin resistance, compromise glucose control and contribute to the development and progression of complications in other organs. (Like the heart and kidneys).
The dentist and the periodontics (dentist expert in pathologies of the gums) can acquire a relevant role in the early detection of undiagnosed diabetes and prediabetes.
Studies that have investigated the underlying mechanisms reveal that hyperglycemia of diabetes contributes to produce an inflammatory hyper-response to oral biofilm (oral bacterial plaque) and compromises tissue repair, which leads to an increase in periodontal destruction. Diabetes can increase the prevalence, even tripling it, in any age group.
Not treating periodontal infections can also affect the general health of patients with diabetes and, for example, increase insulin resistance, compromise glucose control and contribute to the development and progression of complications in other organs. , like the heart and the kidneys. Inform about this relationship and promote, among people with diabetes and health professionals, the necessary oral care would produce great results. The dentist can acquire a relevant role in the early detection of undiagnosed diabetes and prediabetes.
Periodontitis (deep infection of the gum and other tissues that hold the tooth) is the sixth most common complication among people with diabetes. However, a large part of the population, and of patients with diabetes, are unaware of the nefarious implications of periodontal disease in the onset and development of complications associated with diabetes (retinopathy, neuropathy, nephropathy, cardiovascular diseases).
In recent years it is being confirmed that the association between diabetes and periodontal disease is bidirectional, that is, that not only diabetes increases the risk of suffering periodontal diseases, but that periodontal diseases can affect diabetes, impairing control of glycaemia.
Diabetes and periodontitis and their reciprocal influence
The mechanisms that explain this bidirectional relationship are complex. On the one hand, the existence of problems in the gums have negative consequences for people with diabetes who have diminished their response to infections. Even the characteristic loss of teeth that accompanies advanced periodontitis will have repercussions on the diet and, therefore, on the important dietary habits that people with diabetes should follow. Also oral health and healthy teeth are essential to maintain an adequate body image, social relationship and personal self-esteem. Therefore, a good treatment and control of periodontitis facilitates the control of diabetes, decreasing the risk of complications derived from it, and improves the quality of life of people with diabetes.
Why does diabetes affect periodontal diseases?
The increase in blood sugar causes a series of changes in the gingiva that facilitate the development of periodontal disease: it diminishes the activity of defense cells and alters the vascularization of the tissues. These changes cause a greater susceptibility to the action of bacteria, which increases the risk of infections. But, in addition, it hinders the ability of the gum to heal. All this causes the action of bacteria to be more aggressive in patients with uncontrolled diabetes, resulting in greater loss of the bone that supports the teeth.
Why do periodontal diseases affect diabetes?
Periodontitis can initiate or increase insulin resistance in a similar way as obesity does, favoring the activation of the systemic immune response initiated by cytokines. Chronic inflammation generated by the release of these mediators of inflammation increases insulin resistance and depletion of the beta cell, which is also influenced by environmental factors, such as low physical activity and inadequate nutrition leading to obesity .
Does oral health predict the onset of diabetes?
Visits to the dentist represent a very important and effective means to detect and combat diabetes, since it would help to identify precociously a these patients (many of whom are not aware that they have diabetes). With the exploration of the mouth, dentists have the opportunity to identify undiagnosed diabetes or prediabetes in dental patients and refer them to the doctor or specialist’s consultation, according to the aforementioned informative report.