Periodontics is a specialized area of dental practice that concentrates on the diagnosis, treatment and prevention of periodontal disease, gingivitis and gum disease, diabetic complications as well as the placement of implants. The main aspect of the process is the treatment of inflammation as a result of disease and bacterial growth due to another condition.
People who suffer from diabetes are more prone to infections than those who do not have diabetes, and a symptom of the affliction that is not widely known is periodontal disease.
Periodontal disease (which is also known as periodontitis or gum disease) is a degenerative condition that will often result in tooth decay and tooth loss if it is not treated. Periodontal disease starts as a bacterial infection in the mouth and progresses to the colonization of the bacteria under the gums. This causes the gums to recede and the bacteria to eventually attack the underlying bone tissue, leading to tooth loosening and loss.
Diabetes itself is too much glucose (or sugar) in the blood. Type II diabetics cannot regulate insulin levels causing the excess glucose to remain in the blood. Type I diabetics produce no insulin at all. The reasons that diabetic people have a higher risk of periodontal disease are as follows:
Increased sugar in the blood – Moderate and severe periodontal disease creates an elevation of sugar in the blood, which is difficult for diabetic people to control. The bacteria in the mouth of diabetics with periodontal disease can cause serious effects.
Thickening of blood vessels – If blood vessels thicken, they are unable to serve their vital function of delivering nutrients and removing waste. The thickened blood vessels are not able to perform the exchange, which leads to waste products being left in the mouth, worsening the bacterial issues and leading to tooth decay and loss.
Smoking – Smoking or using tobacco products puts everyone at risk, however diabetics who smoke increase the risks of oral issues exponentially. Tobacco use slows the healing processes in the mouth, and combined with diabetes the issues are compounded. Diabetic smokers aged 45 and over are twenty times more likely to develop periodontal disease.
Poor oral hygiene – It is even more important for diabetics to brush, floss and keep immaculate oral health conditions than people without diabetes. The excess sugars in the mouth as well as the compromised waste removal systems provide an ideal environment for bacteria to colonize and destroy the gums and bone which holds teeth in place.
Diagnosis and Treatment
People suffering from any type of diabetes should see the dentist at least twice per year for checkups and professional cleanings. It is well documented that ongoing non-surgical periodontal treatments will lower the HbA1c (hemoglobin molecule blood test) count by as much as 20% in a six month period.
Your dentist during your exam will assess family history and dental X-rays, as well as the condition of the gums, teeth and underlying jawbone. There may be a necessity for your dentist work in conjunction with other doctors to ensure that both the diabetes and the gum disease are being managed and controlled.
The non-surgical procedures that will be performed by the dentist and dental hygienist include deep scaling, where calculus (tartar) will be removed from the teeth above and below the gumline, and root planing, where the root of the tooth is smoothed down to eliminate any remaining bacteria.? Antibiotics may be applied to the gum pockets to promote healing.
Before and after periodontal treatment, the dentist and hygienist will recommend proper home care and oral maintenance as well as prescribing prescription mouthwashes which serve to deter further bacteria colonization.