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Sun Times Feature Story

The South Florida Sun Times


Disease Connection

Understanding The Disease & Its Risks Can Motivate You Into Taking Action

Diabetes is a very deceptive disease with some surprising statistics. It affects approximately 25.8 million people, according to the Centers for Disease Control and Prevention, one-third of people with diabetes have severe periodontal (gum) disease.

Periodontal disease in diabetic patients can ultimately result in the loss of one or more teeth. In fact, the American Dental Association published a recent study that linked one in five cases of total tooth loss to diabetes.

Understanding Periodontal Disease Like diabetes, periodontal disease can be a warning. As detailed by the National Institute of Dental and Craniofacial Research, gum disease starts when bacteria in your mouth forms a sticky plaque biofilm that adheres to your teeth, especially around the gum line. If not removed regularly and thoroughly, the bacteria in the plaque creates toxins that cause inflammation of your gums. Symptoms of this first stage of gum disease, called gingivitis, are red, swollen and bleeding gums.

If untreated, gingivitis progresses into periodontitis. As more plaque forms on your teeth, at the gum line and under your gums, it eventually hardens into tartar. This causes your gums to pull away from your teeth and form loose pockets. The bacterial toxins create an infection within the pockets that starts to destroy the bone and ligaments surrounding your teeth. Without bone and strong connective tissue to support your teeth, they will begin to loosen, and you may eventually have to have teeth removed.

Tooth loss is a major problem for people 60 years of age and older. Tooth loss can lead to difficulty chewing and speaking, feeling self-conscious about one’s appearance and social stigma. "Although the prevalence of tooth loss has declined over the past few decades, it still is a significant public health problem that will continue to affect the baby boomer generation in the United States," Dr Bobadilla says.

The Diabetes-Periodontal Disease Connection
If you are diabetic, you know that high blood sugar levels put you at risk for problems with your kidneys, eyes and heart. In addition, diabetes causes your healing process to be slower and compromises your resistance to infections; this increases your susceptibility to developing periodontal disease. These two factors make treating periodontal disease in diabetic patients more difficult and accounts for why gum disease in diabetics may be more severe.

Here's some good news, however: According to the American Dental Association, while on the one hand high blood sugar does create a risk for periodontal disease, on the other hand, treating gum disease can help diabetics control their blood sugar levels.

Preventing Tooth Loss
Losing teeth to periodontal disease does not have to be your destiny. Understanding the disease and its risks can motivate you into taking action. Visit your dentist for regular exams and professional cleanings, and make sure to update your dentist on your diabetic status, including your blood sugar levels and any new medications you may be taking. Call your dentist right away if you have any of the following symptoms: Red, swollen or bleeding gums, bad breath, difficulty chewing, receding gums or sensitive or loose teeth.

An impeccable oral care routine can help you prevent periodontal disease. Brushing at least twice a day and flossing daily is a must. Be sure to replace your toothbrush every three to four months, since toothbrushes harbor bacteria. Also, your dentist may recommend a prescription-strength, anti-microbial rinse, such as Colgate® PerioGard®, to help you fight gingivitis and promote gum healing.

Work with your dentist to develop a specific plan to keep your mouth healthy. When your periodontal health is good, your blood sugar levels are much easier for you to control, and vice versa. You don't have to be another tooth-loss statistic!

For the study, the researchers looked closely at data from the National Health and Nutrition Examination Survey (NHANES) between 2003 and 2004. Information about the oral health exams and the diabetes status of 2,508 survey participants, 50 years of age and older, were evaluated by the researchers.

The results of the study showed that 28 percent of people with diabetes had lost all of their teeth, compared to 14 percent of people who did not have diabetes. The study authors listed long-term gum disease, tooth decay and cavities as the primary reasons for tooth loss in adults.

People with low income and less education were more likely to have complete tooth loss, which may have to do with access to proper dental care. Only 19 percent of people who never smoked had total tooth loss, compared to 43 percent of smokers.
People with diabetes who had lost some, but not all, teeth were missing an average of 10 teeth, compared to 7 teeth for people without diabetes.

"These study results revealed that adults with diabetes are at higher risk of experiencing tooth loss and edentulism (complete tooth loss) than are adults without diabetes. One of every five cases of edentulism in the United States is linked to diabetes," the authors concluded.

The results of this study were consistent with results found in two other large studies that looked at tooth loss among people with and without diabetes.

The authors suggested that healthcare providers work to educate patients with diabetes about the importance of oral health care in this high-risk group. This study gives additional support for the assertion that diabetes is an independent risk factor for tooth loss.

Dr. Bobadilla said 'What is clear is that people can reduce their risk of periodontal disease by regularly visiting the dentist.

'Check-ups and treatment for periodontal disease may also reduce the risk of cardiovascular disease. As a result, it is vital for people to go through basic periodontal screening at least once a year so that a thorough inspection of periodontal tissues can be achieved.' An Australian study last year found women with gum disease took an extra two months to get pregnant compared with women with healthy teeth and gums.

It took around seven months on average for women with poor oral hygiene to conceive, but just five months for those who brushed their teeth properly.

Other researchers found a link between high levels of dental plaque, or bacteria, and cancer death up to 13 years earlier than expected.

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