DIABETES, AN ENEMY OF DENTAL HEALTH
Periodontal diseases are affecting the periodontium, i.e., the tissues that hold the teeth. They are infectious diseases caused by bacteria, although they can be caused by other factors, such as genetics or environmental issues.
They are divided into two major groups. When only the gum is affected, causing a reversible inflammation, We speak of Gingivitis. On the other hand when this inflammation is kept for a long time and added other factors, starts the periodontitis, usually known (but incorrectly), as pyorrhea. In this case, it not only causes swelling in gums, but also a more profound destruction in other tissues of periodontal - alveolar bone, the foundation of the tooth and periodontal ligament- forming a bag under the gum that collects a large amount of bacteria and endangers the survival of the tooth.
And what are the consequences of these diseases? Its effects may be local (in the mouth) or systematic, in the rest of the body. When the condition is local tooth loss can occur, bleeding gums, pain, bad breath, etc; While in the rest of the body, when the bacteria pass into the blood, they may cause cardiovascular diseases, decompensation diabetes and others.
Did you know that in recent years found that the relationship between diabetes and periodontitis is bidirectional? Diabetes increases the risk of periodontal disease, and these diseases may affect diabetes damaging blood glucose control. The mechanisms that cause this bidirectionality are really complex.
HOW PERIODONTITIS AFFECTS DIABETES?
Periodontitis can start or increase the insulin resistance, favouring the activation of the systematic immune response initiated by cytokines. We can then say that periodontal diseases may affect diabetes. In a clinical study developed for two years, it was noted that the control of blood glucose in patients with diabetes type 2 with a periodontal disease is worse than in the ones who don't have it. It has also been observed that patients with periodontal disease are more likely to develop this type of diabetes. Several studies carried out in patients with diabetes type 2 have come to the conclusion that the periodontal treatment in these patients, allows the improvement of blood glucose levels. Researchers have also come to the conclusion that, cardiorenal mortality risk is three times higher in diabetics with an advanced periodontitis, than in diabetic patients without a periodontal disease.
CONSEQUENCES OF PERIODONTAL DISEASE IN DIABETES
On the other hand, diabetes causes an inflammatory response. People with diabetes are more likely to suffer from oral diseases exacerbated towards bacteria and, what is most important, This disease alters the ability of resolution of infection and the ability to repair, which accelerates the destruction of tissues. It has been found that periodontal diseases are more frequent in the diabetic than in patients without this pathology. It has also been shown that the risk of complications associated with diabetes (including periodontal diseases) are related to the duration of diabetes and its proper control.
A poorly controlled diabetes means an increased risk of periodontal diseases and an increased risk of the loss of the alveolar bone. For this reason, diabetic patients are more likely to suffer from other oral diseases than those who are not. The treatment of periodontal diseases, is as effective in diabetic patients as it is in those who are not. Therefore, it is very important to educate patients with diabetes on the importance of maintaining a good oral health as part of the disease control.
Dental professionals can help identifying diabetic patients and recommending the most appropriate treatment in each case.