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Periodontal Disease and Diabetes

It is well documented that people who suffer from diabetes are more susceptible to developing infections than non-diabetes sufferers.  It is not widely known that periodontal disease is often considered the sixth complication of diabetes, particularly when the diabetes is not under proper control.

Periodontal disease (often called periodontitis and gum disease) is a progressive condition that often leads to tooth loss if treatment is not promptly sought.  Periodontal disease begins with a bacterial infection in the gingival tissue which surrounds the teeth.  As the bacteria colonize, the gum pockets become deeper, the gums recede as tissue is destroyed and the periodontitis eventually attacks the underlying bone tissue.

Diabetes is characterized by too much glucose (or sugar) in the blood.  Type II diabetics are unable to regulate insulin levels which means excess glucose stays in the blood.  Type I diabetics do not produce any insulin at all.  Diabetes is a serious condition which can lead to heart disease and stroke.

Reasons for the Connection

Experts suggest the relationship between diabetes and periodontal disease can worsen both conditions if either condition is not properly controlled.

Here are ways in which diabetes and periodontal disease are linked:

  • Increased blood sugar – Moderate and severe periodontal disease elevates sugar levels in the body, increasing the amount of time the body has to function with high blood sugar.  This is why diabetics with periodontitis have difficulty keeping control of their blood sugar.  In addition, the higher sugar levels found in the mouth of diabetics provide food for the very bacteria that worsen periodontal infections.

  • Blood vessel thickening – The thickening of the blood vessels is one of the other major concerns for diabetes sufferers.  The blood vessels normally serve a vital function for tissues by delivering nutrients and removing waste products.  With diabetes, the blood vessels become too thick for these exchanges to occur.  This means that harmful waste is left in the mouth and can weaken the resistance of gum tissue, which can lead to infection and gum disease.

  • Smoking – Tobacco use does a great deal of damage in the oral region.  Not only does tobacco use slow the healing process, it also vastly increases the chances of an individual developing periodontal disease.  For diabetics who smoke, the risk is exponentially greater.  In fact, diabetic smokers aged 45 and over are twenty times more likely to develop periodontal disease.

  • Poor oral hygiene – It is essential for diabetics to maintain excellent levels of oral health.  When daily brushing and flossing does not occur, the harmful oral bacteria can ingest the excess sugar between the teeth and colonize more freely below the gum line.  This exacerbates the metabolic problems that diabetes sufferers experience.

Diagnosis and Treatment

It is of paramount importance for people suffering from any type of diabetes to see the dentist at least twice yearly for checkups and professional cleanings.  Studies have shown that simple non-surgical periodontal treatments can lower the HbA1c (hemoglobin molecule blood test) count by as much as 20% in a six month period.

The dentist will use medical history, family history and dental X-rays to assess the risk factors for periodontal disease and determine the exact condition of the gums, teeth and underlying jawbone.  If necessary the dentist will work in conjunction with other doctors to ensure that both the diabetes and the gum disease are being managed and controlled as effectively as possible.

Non-surgical procedures performed by the dentist and dental hygienist include deep scaling, where calculus (tartar) will be removed from the teeth above and below the gumline, and root planing, where the root of the tooth is smoothed down to eliminate any remaining bacteria.  Antibiotics may be applied to the gum pockets to promote healing.

Before and after periodontal treatment, the dentist and hygienist will recommend proper home care and oral maintenance as well as prescribing prescription mouthwashes which serve to deter further bacteria colonization.

If you have questions or concerns about diabetes or periodontal disease, please contact our office.

Testimonials.

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Testimonials

Dr. Hekmat and all of his staff are gentle and friendly. They take the fear out of going to the dentist. He has done quality work on my teeth for the last three years and fixed problems I had from previous, poor quality dental work too! I am more than willing to drive 40 miles from where I live because I've never had such a great dental experience anywhere else!

Taylor w

Dr. Hekmat is absolutely wonderful, I couldn't imagine going to anyone else. He and his entire staff are caring and knowledgable; the quality of care is as good as it gets.
This is not your typical dentist experience. When I walk in today for my appointment, there was no check-in process- the assistant working at the front desk recognized me and told me the hygienist would be with me shortly (2 minutes later, right on time). They actually take the time to get to know their patients, which is especially comforting for those of us who get a little antsy when it comes time for a dental appointment.
The facility is top-notch. It's incredibly clean, TV in the lobby, and the chairs have massagers in the back so you can focus on something besides having your teeth cleaned. The pictures on their website might look too good to be true, but it's just genuinely that nice.
Dr. Hekmat and his staff are all phenomenal. They know what they're doing, take the time to explain what they're doing, and to answer questions. I would recommend Dr. Hekmat to anyone looking for a dentist or to change dentists, he's the best!

Chelsea S.

Dr. Hekmat's offices are so clean, soothing, and modern that it almost (ALMOST ... it's still the dentist!) feels like visiting the spa when you visit. I drive up all the way from the UTC area because I trust him and his staff with my teeth and my jittery nerves! They even take a photo of you at your first visit, so that when you come back, the receptionist greets you by name and already knows who you are - very welcoming, and a unique touch. Even the lighting is warm and relaxing, and the view from the chair is of a large, grassy pond filled with ducks.

Dr. Hekmat himself is friendly, calming, and talented. He replaced several silver filings with white filings for me - and he was really, really fast. Which was really appreciated by me, because I'm a big baby when it comes to the dentist. Several months later, and I'm silver-free and my filings have done great.

Ann M.

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