Diabetes is a disease that affects almost 7% of Canadians. It shares an interesting relationship with periodontal disease, and therefore periodontists have an important role in the diagnosis and management of patients with diabetes.
Diabetes is a condition that impairs one’s ability to regulate glucose. Glucose is a form of blood sugar, and without rigid control through normal body systems, glucose can damage blood vessels and other tissues. Blood vessels feed every major body organ, such as the heart and kidneys, and are an essential source of nutrients for the entire body. With poor glucose control, every organ in the body is susceptible to vessel damage. Tissues that have damaged blood vessels, have decreased blood flow, and consequently, impaired function and healing.
In contrast to diabetes, bacteria initiate periodontal disease. It is the bacteria, coupled with the body’s own immune response, attempting to eradicate the bacteria, that begins the process of tissue inflammation and bone loss which exists in periodontitis. Any condition, such as diabetes, that affects the body’s ability to heal will have an affect on periodontitis.
Randomized controlled clinical trials have shown that diabetic patients with healthy periodontal conditions have better control of their diabetes. Likewise, patients who have poor control of their diabetes are likely to experiences a worsening of their periodontal condition. Because of the link between these two diseases, we’ve decided to point out a few easy ways for diabetics to maintain good oral health.
Here are GRAFT’s top 5 tips for good oral health for diabetics:
1. Effective brushing AND flossing twice a day. The practice of brushing and flossing removes bacteria and plaque from the teeth. Removing plaque (i.e. disturbing bacteria) twice each day, prevents the bacteria from producing harmful by-products that damage teeth and gums. Your toothbrush does a good job reaching 3 of the 5 tooth surfaces, but you will also need dental floss to reach the other 2 surfaces, which are between your teeth.
2. Regular visits to your hygienist for cleanings – Even champion “toothbrushers” accumulate some hardened plaque, which is known as calculus. Once formed, calculus is impossible to remove with a toothbrush and must be removed with scaling. While most people regard every 6 months as the “norm” for cleanings, the frequency of your cleanings is actually best determined by your presumed risk of developing periodontitis. For diabetics, with an increased risk of periodontitis, this often translates into more frequent visits to the hygienist for cleanings.
3. Control of your blood glucose levels. Most diabetics are well versed in the many ways in which they can control their blood sugar. In the early stages of diabetes, blood sugar is controlled through diet, exercise, and medication (i.e. metformin, glyburide). At some point, patients may also require insulin.
Most diabetics check their blood sugar three or more times a day. Frequent testing allows for diet and medication adjustments as needed. An additional test that is required to assess one’s recent blood sugar control is an HbA1c test. Diabetics typically have this test every 3 months, and the HbA1c results are an important measure for periodontists involved in the care of diabetics. This is because an elevated HbA1c may present an increased risk for poor healing after periodontal treatment.
4. Quit smoking. Interestingly, smoking and diabetes are the two strongest positive predictors for developing periodontitis. What this means is that they’ve been studied extensively, and even when all other factors are accounted for, they increase a person’s risk of developing periodontitis more than any other known factors. It’s never too late to quit smoking.
5. Awareness – Be sure to let your dentist know that you have diabetes. Make them aware of any medications you are taking, and if there have been any changes to your general health. In addition, let us know how you are feeling. If needed, we can adapt your treatment to suit the day.
At GRAFT your oral health is most important to us. If you have any questions, or would like more information on how to prevent periodontal disease, please contact the office today. We are here to help.