Gum disease and diabetes are linked

Dr. Shannon Mills has more than four decades of experience as a dentist and his favorite topic is a simple but profound one — understanding the relationship between good overall health and good dental health.
"It's really important because a lot of people don't understand or don't know the relationship that exists," said Mills, a scientist and vice president of professional relations with Northeast Delta Dental, the region's largest dental insurance administrator. "Too many think that dentistry and medicine are separate and that teeth are independent. The reality is they are all connected to the body and our immune systems."
A prime example, Mills said, is the connection between gum disease and diabetes.
"We've known this for years; were talking about it when I was in dental school, but the research has made it clearer," he said.
The U.S. Centers for Disease Control and Prevention estimates that 26 million Americans suffer from diabetes. Another 57 million — about a fourth of U.S. adults — have pre-diabetes, which means their blood sugar levels are higher than normal, but not yet high enough to be classified as Type 2 diabetes in adults. Type 1 is normally associated with juvenile diabetes.
November is National Diabetes Month and, according to the American Diabetes Association, controlling blood sugar levels is a key to preventing many serious complications of diabetes such as heart disease, kidney disease and stroke.
Mills said research suggests a two-way relationship between serious periodontal (or gum) disease and diabetes. Not only are people with diabetes more susceptible to severe gum disease, but gum disease may have the potential to affect blood glucose control and contribute to the progression of diabetes. People with diabetes tend to develop periodontal disease earlier in life, and more severely. Instead of losing their teeth from gum disease in their 60s, they might begin losing teeth in their mid-40s. Mills said that smokers with diabetes are especially at risk for gum disease and tooth loss and that stopping smoking can help in the treatment of both diabetes and gum disease.
"It's the single-most important thing one can do," he said about the importance of smoking cessation on oral health.
According to the ADA, people with diabetes are at an increased risk for serious gum disease because they are generally more susceptible to bacterial infection, and have a decreased ability to fight bacteria that invade the gums. If blood glucose levels are not properly controlled, people are more likely to develop serious gum disease and lose more teeth than non-diabetics. Like all infections, serious gum disease may be a factor in causing blood sugar to rise and may make diabetes harder to control. Oral problems associated with diabetes can also include thrush, an infection caused by fungus that grows in the mouth, and dry mouth which can cause soreness.
Mills said that regular dental checkups and examinations are critical.
"If you have diabetes, tell your dentist," he said. "If your dentist sees gum disease developing, he will likely ask if you have diabetes. If not, check with your doctor to be tested."
Mills said those who would like to learn more and do a self-assessment online, can visit mydentalscore.com. Upon completion of the self-exam they will get a score and Mills suggests discussing the results with their dentists.
While not enough conclusive research has been conducted, Mills believes it's only a matter of time until serious gum disease is more definitively connected to heart attacks and strokes.
For more information, visit www.mydentalscore.com or www.nedelta.com.
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