Periodontal or gum disease occurs when the gums become infected and inflamed. This condition can affect anyone, but there's a strong link between periodontal disease and diabetes.
It’s what is known as a “bidirectional relationship.” Gum disease causes systemic inflammation that can increase the risk of developing type 2 diabetes—and diabetes more than doubles the risk of developing periodontal disease. Periodontal disease also makes blood sugar control more challenging, while poorly controlled diabetes increases the risk of severe gum disease, including tooth loss.
The good news is that preventing and treating gum disease can reduce your risk of developing diabetes and, if you’ve already been diagnosed with diabetes, help lower your blood sugar and stave off diabetic complications.
Diabetes Effect on Teeth and Gums
The main culprit behind the higher risk of periodontal disease in diabetes is damage to the blood vessels due to elevated blood sugar levels. Because reduced blood flow impairs the delivery of nutrients and the removal of wastes in the tissues, the gums become less resistant to infection, setting the stage for periodontal disease.
People with diabetes also have higher levels of glucose in the fluids of the mouth, and glucose is a favorite food of oral bacteria. This includes Streptococcus mutans, which produce acids that eat through the enamel of teeth and cause decay, as well as bacteria that directly infect the gums.
Inflammation is another link between periodontal disease and diabetes. Gum inflammation is a defining feature of periodontal disease. Low-grade systemic inflammation is also an underlying cause of diabetes and other chronic diseases, and it affects tissues throughout the body, including the gums.
If you have any signs of periodontal disease, such as red, sore, swollen, or bleeding gums, loose or sensitive teeth, or bad breath, see your dentist at once.
Program for Preventing Periodontal Disease
Here are some suggestions for keeping your gums healthy and preventing (and even treating) periodontal disease.
- Brush, floss, and see your dentist regularly. Brushing twice a day, flossing daily, and getting professional dental cleanings twice a year may be inconvenient, but they beat the heck out of gum surgery, tissue/bone grafts, and tooth loss. Consider using an electric toothbrush, such as Sonicare, which transmits acoustic energy that helps remove plaque between the teeth and below the gum line, the area normally reached only by flossing.
- Clean your tongue. The protective mucous coating on your tongue is an excellent hideout for bacteria. You can brush your tongue along with your teeth or borrow a tool from Ayurvedic medicine and scrape your tongue once a day. Curved thin metal strips designed for this purpose not only remove plaque-forming bacteria but are also one of the most effective breath fresheners around.
- Take coenzyme Q10 (CoQ10). CoQ10 has been shown to reduce inflammation and other signs of gum disease. The recommended daily dose is 100 mg once or twice a day.
- Add vitamin C and zinc. Vitamin C is required for the production of collagen, which is an important structural component of oral tissues. Zinc stabilizes cellular membranes, inhibits plaque growth, and hastens wound healing. Deficiencies in these nutrients are common in patients with periodontal disease. I suggest taking 500–1,000 mg of vitamin C and 30 mg of zinc daily, preferably in divided doses.
- Suck on probiotic lozenges. Certain probiotics have proven benefits for oral health. Two specific strains, Streptococcus salivarius (S. salivarius) BLIS K12 and M18, help restore microbial balance in the mouth and throat. In addition to helping keep your gums and teeth healthy and your breath fresh, these probiotics have also been shown to stave off sore throats, colds, postnasal drip, and ear infections.
- Chew xylitol gum. Xylitol is a natural sugar alcohol that helps prevent tooth decay and periodontal disease. It raises the pH level of the mouth, making it less hospitable to bacteria that cause cavities and gum disease. For optimal protection, chew on xylitol gum (or suck on hard candies/lozenges or use a xylitol mouth spray) up to five times a day. Xylitol is also an excellent dietary sweetener. It looks and tastes like sugar, but because it is slowly and only partially absorbed by the body, it has a minimal effect on blood sugar.
- Stop smoking. Smoking dramatically increases the risk of both periodontal disease and diabetes—and smoking plus diabetes is a double whammy. If you smoke, do whatever it takes to quit now.
- Control/prevent diabetes. Last but not least, take steps to prevent or control diabetes. As noted above, chronically high blood sugar dramatically increases the risk and severity of periodontal disease.
It has been said that oral health is an indicator of your overall health, and there is a lot of truth to this. In addition to diabetes, periodontal disease also increases the risk of other health concerns such as heart disease, stroke, premature birth, and even cancer.
Everyone should adopt a program for preventing periodontal disease, but if you have diabetes, you must be extra vigilant. In addition to tending to your oral health, get serious about diabetes prevention and treatment. It’s a win-win on all fronts.