Diabetes and Periodontal Disease
How Does Periodontal Disease Develop? continued...
Periodontitis. Periodontitis is an infection of the tissues that hold
the teeth in place. In periodontitis, plaque builds and hardens under the gums.
The gums pull away from the teeth, forming "pockets" of infection. The
infection leads to loss of the bone that holds the tooth in its socket and
might lead to tooth loss.
There are often no warning signs of early periodontitis. Pain, abscess, and
loosening of the teeth do not occur until the disease is advanced. Since
periodontitis affects more than just the gums, it cannot be controlled with
regular brushing and flossing. Periodontitis should be treated by a
periodontist (a gum disease specialist) or by a general dentist who has special
training in treating gum diseases.
How Is Periodontal Disease Treated?
Plaque Removal. Treatment of periodontitis depends on how much damage
the disease has caused. In the early stages, the dentist or periodontist will
use deep cleaning to remove hardened plaque and infected tissue under the gum
and smooth the damaged root surfaces of teeth. This allows the gum to re-attach
to the teeth. A special mouthrinse or an antibiotic might also be prescribed to
help control the infection.
Deep cleaning is successful only if the patient regularly brushes and
flosses to keep the plaque from building up again.
Periodontal Surgery. Gum surgery is needed when periodontitis is very
advanced and tissues that hold a tooth in place are destroyed. The dentist or
periodontist will clean out the infected area under the gum, then reshape or
replace the damaged tooth-supporting tissues. These treatments increase the
chances of saving the tooth.
If You Have Diabetes...
- It's important for you to know how well your diabetes is controlled and to
tell your dentist this information at each visit.
- See your doctor before scheduling treatment for periodontal disease. Ask
your doctor to talk to the dentist or periodontist about your overall medical
condition before treatment begins.
- You may need to change your meal schedule and the timing and dosage of your
insulin if oral surgery is planned.
- Postpone non-emergency dental procedures if your blood sugar is not in good
control. However, acute infections, such as abscesses, should be treated right
- For the person with controlled diabetes, periodontal or oral surgery can
usually be done in the dentist's office. Because of diabetes, healing may take
more time. But with good medical and dental care, problems after surgery are no
more likely than for someone without diabetes.
- Once the periodontal infection is successfully treated, it is often easier
to control blood sugar levels.
Are Other Oral Problems Linked to Diabetes?
Dental Cavities. Young people with IDDM have no more tooth decay than
do nondiabetic children. In fact, youngsters with IDDM who are careful about
their diet and take good care of their teeth often have fewer cavities than
other children because they don't eat many foods that contain sugar.