Diabetes and Oral Health

In general, people have difficulty comprehending how Diabetes Mellitus can be related to oral health. Diabetes itself is not a death sentence provided it is kept under control. However, uncontrolled Diabetes can lead to severe health issues including dental problems.

How Diabetes Causes Destruction ?

1. INCREASED INFECTION and DELAYED HEALING : Immunologic research has shown several defects like impaired migration, intracellular killing, chemotaxis and reduced phagocytic capabilities of polymorphonuclear leukocytes (PMNL)in host immune defense mechanisms. These may be attributed to the decreased PMNL membrane fluidity. This may make the diabetic person prone to infection and delayed healing.

2. BLOOD VESSEL CHANGES : Macrovascular disease and microvascular dysfunction (i.e., both the large and the small blood vessels) may result in compromised local circulation leading also to delayed response to infection and impaired wound healing. Thickening of blood vessels is a complication of diabetes that may increase risk for periodontal (gum) disease. Thickened blood vessels impair the flow of nutrients to the tissue and the removal of harmful wasts products of the tissue. This can increase the risk of the gingival tissue and the supporting structures to infection and destruction.

3. BACTERIA : Most of the virulent micro-organisms thrive on sugar. Uncontrolled diabetes results in high blood glucose level (hyperglycemia) and therefore, high glucose level in the tissue fluids. That in turn harbors those germs to cause tissue destruction.

Diabetes can also result in exaggerated host response to the local microbial factors like endotoxins (the chemicals that are released in the event of the death of those micro-organisms). This results in unusually destructive periodontal breakdown.

4. HYPERGLYCEMIA also causes oxidative stress in tissue; stimulates epithelial cell proliferation, vascular permeability and increases apoptosis (programmed cell death). Hyperglycemia alter the normal metabolic pathways. The byproducts of altered metabolic processes are the destructive free radicals that also cause tissue destruction.

Points to Remember :

1. Good diabetic control is the best protection against periodontal disease.

2. Smokers are 5 times more likely than nonsmokers to have periodontal disease. For smokers with diabetes, the risk is even greater. A person who is 45 or older with diabetes, is 20 times more likely than a person without these risk factors to get severe periodontal disease.

3. Dry mouth or "Xerostomia" is often a symptom of undetected diabetes. This can lead to soreness, ulceration, infections, and dental decay. Diabetic patients may have unusual redness and/or tenderness of the tissue in the front of the mouth. It can also be throughout the mouth.

4. Poor oral hygiene can compound the destructive nature of periodontal breakdown.

5. Go to your physician on a regular basis to get diagnosed for Diabetes. Early diagnosis is the best possible way to minimize the risk of damage. The same is true in the case where diabetes has already been established. Careful monitoring of the blood glucose level and HbA1C shows how well the disease has been kept under control. Regular dental visits are also very crucial.