Page 25 - Diabetes

CARE

of Diabetes Care

treated, the bacteria produce chemicals that can affect more difficult to control your diabetes.”
your jaw and gums, resulting in loosened or missing teeth. There are indications that severe inflammation linked
Symptoms include bleeding and swelling in your gums, to PD may increase insulin resistance and has the potential
bad breath, a constant bad taste, frequent abscesses, loose to destroy insulin-producing t-cells. Either of these can
teeth and receding gums. make diabetes worse.
Especially for individuals with diabetes, a periodontist is The changes diabetes brings about in the blood vessels
part of the treatment team early on. Periodontists treat those also play a part in periodontal disease. With less circulation
with severe gum disease and complicated medical histories. to the gums, fewer white blood cells are drawn to the area
“The periodontist has additional training beyond den- to fight the infection. The lack of adequate circulation also
tal school (2-3 years) in treating periodontal disease and brings about an increase in the activity of collagenase. Since
diseases affecting the jaw bone,” says Sally J. Cram, DDS, the gums mainly consist of collagen, a substance essential
a consumer advisor and spokesperson for the American for gum healing, they are more actively being broken down.
Dental Association. “They have the training and skills to do Other risk factors at work (in addition to diabetes)
more complex treatments including surgery, bone grafting include: smoking; poor oral hygiene; stress; heredity;
and implants.” crooked teeth; underlying immune system disorders such
It is important to ask if your general dentist feels com- as AIDS; bridges or dental appliances that no longer fit
fortable treating your periodontal problems. If he or she is properly; and female hormonal changes, such as with
unable to answer your questions, address your concerns and pregnancy or the use of oral contraceptives.
provide education around controlling periodontal disease,
then you may want to see a specialist. Diabetes Type Not Important Difference
Presently, there are no indications that one type of diabetes
PD Impact on Diabetes Control puts you at higher risk for dental problems than the other.
“The biggest risk factor for PD is control of the diabetes,” “We have always assumed that Type 1 diabetes was medically
says Cram, who is also in private practice in the Washington, more severe than Type 2,” says Miriam R. Robbins, DDS, chair
DC, area. “On the other side, those with untreated gum of the Department of Dental Medicine at NYU Winthrop
disease have a much harder time controlling their blood Hospital in Mineola, NY, and president of the American
Shutterstock/Naypong sugar levels because of the constant challenge of inflam- Academy of Oral Medicine. “What we are finding is that the
mation. The non-controlled diabetes can put you at higher length of time you have diabetes increases the likelihood
risk for PD, but having untreated PD can make it much of these complications. In the past, Type 1 was most often
DiabetesSelfManagement.com 23