Periodontal disease, also known as gum disease, is the leading cause of tooth loss in adults. It develops when the gum tissue, especially the deep supporting tissue and possibly the bone surrounding the teeth, becomes infected and inflamed. It can be the result of poorly controlled diabetes and has also been linked to heart disease and stroke.
In the initial stage, gum disease is called gingivitis and is reversible. However, when bone loss occurs, treatment is much more difficult. Gum disease can be prevented with good oral hygiene and regular professional dental care.
Symptoms
Gum disease starts with plaque, a sticky white substance that covers the teeth. It is created when bacteria in the mouth mix with saliva and leftover starchy foods and sugar in your diet.
If plaque is not properly removed from the teeth by brushing and flossing, it can build up below the gum line and harden into a substance called tartar. Calculus is more difficult to get rid of than plaque and usually requires professional removal by a dentist.
If tartar is not removed, periodontal disease can develop, causing any of a number of tell-tale signs and symptoms:
- Bad breath that doesn’t go away
- Red or swollen gums
- Gum sensitivity or bleeding
- Painful chewing
- Loose teeth
- Sensitive teeth
- Receding gums or larger appearing teeth
Reasons
The main cause of gum disease is the buildup of plaque and tartar that eventually leads to inflammation and infection. Studies show that people with diabetes who do not have adequate blood sugar control appear to develop gingivitis more often and more severely than those who have their diabetes well managed.
Factors that contribute to the increased risk and severity of periodontal disease in people with diabetes include:
- Diabetes slows circulation, which can make gum tissue susceptible to infection.
- Diabetes reduces the body’s resistance to infection, which increases the chance of gum infection.
- High levels of glucose in saliva promote the growth of bacteria that cause gum disease.
- People with diabetes who smoke are much more likely to develop gingivitis than people who smoke and do not have diabetes.
- Poor oral hygiene is a major factor in gum disease for everyone, but it is even more so for a person with diabetes.
Diagnosis
Gingivitis at any stage is diagnosed during standard dental cleanings and exams, during which the hygienist and/or dentist will be on the lookout for early signs and symptoms.
They will also measure the depth of the ‘pockets’ around individual teeth. A pocket depth greater than 3mm may indicate periodontal disease.
Your dentist may also take x-rays to look for bone loss.
Treatment and Prevention
If your dentist detects gum disease, he or she will likely recommend dental procedures beyond the standard cleaning you get during exams. These may include scaling to completely remove plaque and tartar from under the gums, root planing, or oral antibiotics to control bacteria. They may also refer you to a periodontist, who specializes in gum disease.
Lifestyle factors can also reduce the risk of developing periodontal disease. When you have diabetes, one of the number one tips is to keep your blood sugar levels under good control.
Here are some other helpful tips for preventing gum disease:
- Do not smoke. Whether you have diabetes or not, smoking makes you two to six times more likely to develop periodontal disease.
- Maintain good oral hygiene and have regular dental check-ups. Brush at least twice a day and floss once a day (preferably before bed). Regular dental cleanings will help remove tartar build-up and treat advanced gingivitis.
- An electric toothbrush, although expensive, can remove plaque from teeth more effectively than a manual brush, making dental checkups easier. Water flossing or tools designed to clean between your teeth, such as a dental pick, may also be helpful.
- For home care, dentists often recommend a simple saline (salt) rinse to help reduce oral bacteria that can worsen gum disease. Once a day or after brushing your teeth before bed, add a spoonful of salt to a mug of warm water. (Any salt, such as table salt, will do.) Stir to dissolve, then use the mixture to brush your teeth for a minute or so. You can use this rinse up to three or four times a week. Finish by pouring plain water into your mouth and spitting.
- Eat a healthy and balanced diet.
A word from Verywell
Maintaining good oral hygiene, along with maintaining stable blood sugar levels, are the best things you can do for the health of your gums and teeth if you have diabetes. As long as you know your teeth, you’ll be able to tell when something feels off—don’t ignore the warning signs. Make an appointment for a dental cleaning and checkup if you notice pain or unusual bleeding in your gums or any of the above symptoms. Dental professionals often catch warning signs early, when they’re much easier to treat – and that’s something you can smile about.
