Diabetes can put you at risk for gum disease and mouth infections

Diabetes can increase your risk for gum disease, mouth infections, and possibly cavities. Janet was eight years old when she got type 1 diabetes; unfortunately, she didn't get the necessary education to help her manage it. By the time she was twenty she'd already suffered multiple diabetic complications, but it was being fitted for dentures - top and bottom - that motivated her to start taking care of her diabetes.

"Because my sugar had been so high for so long, it rotted all my teeth. Sitting in that dentist's chair, I was thinking, ‘I'm twenty-six years old and I'm dealing with something old people get.' I'd had dreams all my life about my teeth falling out, and here it was happening, they were pulling out all my teeth. That was my wake-up call."

Although Janet's story is extreme, Jean Bertschart Roemer, diabetes educator and pediatric nurse practitioner, says it illustrates how serious the risk of periodontal (gum) disease can be with poorly controlled diabetes. Roemer has followed children with diabetes from diagnosis to their early twenties, witnessing how gum and mouth infections occur more frequently in people with diabetes, particularly when blood sugars are consistently high.

At the 2008 ADA Scientific Conference, oral health was a new and hot topic. "One of the many complications of diabetes is a greater risk for periodontal disease," said Maria E. Ryan, DDS, PhD, professor of oral biology and pathology, and director of clinical research for the School of Dental Medicine at Stony Brook University in New York. Persistent high glucose levels in the blood contribute to the destruction of bone and gum tissue, said Dr. George W. Taylor, associate professor of dentistry at the University of Michigan's Schools of Dentistry and Public Health.

Elevated blood glucose levels raise the risk of infection everywhere in your body, including your mouth. Periodontal disease is an infection and chronic inflammation of the tissues surrounding and supporting the teeth. It is a major cause of tooth loss in adults. In periodontitis, plaque hardens into calculus (tartar), gums gradually begin to pull away from the teeth, and pockets form between the teeth and gums.

Awful as this may sound, people often do not know they have periodontal disease because it is usually painless. Robert Eber, DDS, clinical professor of periodontics and oral medicine at the University of Michigan, opened my eyes to the seriousness of periodontal disease when he confirmed that, yes, "size matters."

"In periodontal disease, the total surface area of inflamed soft tissue surrounding a tooth is about the same surface area as the palm of one's hand," said Eber. "Imagine if you had an ulcerated, inflamed area that size on your leg. You wouldn't leave that untreated."

High blood sugars slow the healing process, so mouth infections are harder to treat or eliminate, worsening periodontal disease. At the same time, periodontal disease worsens glycemic control.

The body reacts to gum disease with inflammation, which raises blood sugar and can increase insulin resistance. Dr. Taylor cited several recent studies at the ADA Conference that confirm not only the link between periodontal disease and high blood sugars but also between gum disease and other diabetes complications.

Although periodontal disease makes diabetes worse, it also appears that periodontal treatment can bring about a reduction in the risk for diabetes complications.

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Diabetes can put you at risk for gum disease and mouth infections

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