Diabetes and Periodontal Disease--Part One: Overview

docslotnick
Fri, 24 Mar 2017 20:43:44 +0000
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Diabetes and Periodontal Disease

Part One–Overview

Periodontal, or gum, disease is one of the most prevalent diseases in America. The NIH (National Institute of Heath) and the AAP (American Association of Periodontists) report that over 50% of adults in the US suffer from the most severe form of periodontal disease, periodontitis.
And for people over 60 years of age that figure climbs to about 65%.

So, What Exactly Is Periodontal Disease?

It is defined as inflammation of the gingival tissues, gingival attachment (the fibers that attach the gum tissue to the tooth), the alveolar bone (the portion of the jaw bones that support the teeth), and the periodontal ligament (the ligament that connects the alveolar bone to the teeth). This inflammation is what makes periodontal disease especially dangerous for people with diabetes.

What Does Periodontal Disease Have to Do With Diabetes?

Studies have shown that adults with diabetes are three times more likely to have gum disease than those without diabetes. Also, the degree of hyperglycemia correlates to the severity of gum disease.

But it’s not just your teeth I’m talking about. Gum disease is a little-known but potentially deadly factor for diabetics:

Death from renal disease is three times more likely for diabetics with gum disease compared to diabetics without gum disease.

Death from cardiorenal disease (arteriosclerotic heart disease with kidney disease) is three times more likely for diabetics with gum disease than for diabetics without gum disease.

The degree of hyperglycemia correlates to the severity of gum disease

Diabetics who successfully treat gum disease lower their A1C on average by 0.4%

So, for diabetics, preventing and controlling gum disease is critical to remaining healthy, free of complications and ALIVE rather than dead. And it’s easy - a heck of a lot easier than a kidney transplant.

Help Me! I Don’t Wanna Die!

So now that you understand what periodontal disease is and how it has a profound effect on your diabetes and your general health as a diabetic, you might wonder how to prevent or treat periodontal disease. Not coincidentally, that is the topic for the next article.

From the NIH for all of the biochemists out there:

Schematic representation of the proposed two-way relationship between diabetes and periodontitis. Exacerbated and dysregulated inflammatory responses are at the heart of the proposed two-way interaction between diabetes and periodontitis (purple box), and the hyperglycaemic state results in various proinflammatory effects that impact on multiple body systems, including the periodontal tissues. Adipokines produced by adipose tissue include proinflammatory mediators such as TNF-α, IL-6 and leptin. The hyperglycaemic state results in deposition of AGEs in the periodontal tissues (as well as elsewhere in the body), and binding of the receptor for AGE (RAGE) results in local cytokine release and altered inflammatory responses. Neutrophil function is also altered in the diabetic state, resulting in enhancement of the respiratory burst and delayed apoptosis (leading to increased periodontal tissue destruction). Local production of cytokines in the periodontal tissues may, in turn, affect glycaemic control through systemic exposure and an impact on insulin signalling (dotted arrow). All of these factors combine to contribute to dysregulated inflammatory responses that develop in the periodontal tissues in response to the chronic challenge by bacteria in the subgingival biofilm, and which are further exacerbated by smoking

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