Prevention is in your hands . Timely action and screening can avoid complications related to oral health .
The synergy between sugar and plaque
High glucose is directly proportional to increased plaque formation when sugar combines with starch and carbohydrate-rich food . The sugar-rich food then promotes bacterial growth , making plaque harden over time and converting into tartar that collects above the gumline . Tartar causes the gums to become red , swollen , and bleed easily , causing gingivitis ( Fig . 1 ).
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High Glucose levels Bacterial growth in oral cavity Combine with of starch & carbohydrate rich food Plaque formation Tooth decay , gum disease
What happens after plaque formation ?
When gingivitis is left untreated , it can translate into gum disease called periodontitis . Periodontal diseases are chronic inflammatory processes caused by dental biofilm bacteria around tooth-supporting structures . Periodontal disease can be present as a complication in people with diabetes ( 1 ). Interestingly , the relationship between diabetes and periodontal disease seems bi-directional , meaning that high blood sugar affects oral health , while periodontitis affects glycemic control . ( 2 )( 3 )
Bidirectional Relationship of Periodontitis and Diabetes
In periodontitis , the pockets can form when gums pull away from the teeth and form spaces that can slowly become infected .
This infection can last a long time due to poor glycemic control . The plaque can expand and grow below the gum line resulting in the condition . It can further cause damage to the surrounding tissue and bone that supports the teeth . If periodontitis is not treated , the gums , bones , and tissue supporting the teeth are destroyed , and tooth extraction occurs .
Inflammation is the central feature of the pathogenesis of both DM and periodontal disease . This elevated inflammatory state contributes to macro- ( large vessel ) and microvascular ( small vessel ) complications . Moreover , hyperglycemia ( high sugar ) can activate pathways that increase inflammation , oxidative stress , and cell death . Treatment of chronic periodontitis usually includes .
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oral hygiene instructions , information on diet , and professional evaluation of the teeth and gum .
In summary , patients with diabetes who have periodontal disease have two chronic inflammatory conditions , each of which may influence the other , requiring frequent professional evaluations , indepth and consistent educational fortification by health care providers .
Essential steps to keep the mouth healthy and free from disease :
• The best defence is to maintain tighter glycemic control .
• Conduct timely and regular visits to the dentist twice a year for a cleaning and checkup .
• Discuss your diabetes lab tests and blood sugar levels with the dentist during each visit .
• Avoid meals rich in carbohydrate or brush after eating starchy or carbohydrate food .
• Fluoride protects against tooth decay . Use fluoride toothpaste and an antiplaque dry mouth rinse to brush your teeth at least twice a day .
• Contact your dentist in case of a white tongue or oral ulcers on cheeks that may need antifungal or antibiotic treatment .
• Use dental floss regularly to prevent plaque buildup on the teeth .
• Stop smoking and use of any tobacco products .
Diabetes is a long-term condition that needs diligence and awareness . The good news is , Prevention is in your hands . Timely action and screening can avoid complications related to oral health . Learn what you are up against , and take charge of your dental health .
References :
1 . https :// www . idf . org / aboutdiabetes / what-isdiabetes / facts-figures . html
2 . Sanz M , Ceriello A , Buysschaert M , et al . Scientific evidence on the links between periodontal diseases and diabetes : Consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International Diabetes Federation and the European Federation of Periodontology . J Clinical Periodontol2018 ; 45 ( 2 ): 138
The advantageous effect of periodontal treatment on the metabolic control of diabetes exemplifies the potential value of an increased understanding of the concepts of biological credibility .
3 . JADA 2006 ; 137 ( 10 supplement ): 26S-31S .
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