Oral health is closely related to overall body health. “And not just because some general diseases also show up in the mouth,” explains Professor Dr. James Deschner in his patient guide “Healthy begins in the mouth”. Periodontal disease can increase the risk of other diseases. “This also applies to diabetes,” says the director of the polyclinic for periodontology and tooth preservation at the University Medical Center Mainz.
More than just bleeding gums
Periodontitis is an inflammation of the periodontium. It affects not only the gums, but all of the tissue and jawbones that support the teeth. Symptoms include bleeding gums, dry mouth, receding gums and bad breath. Sometimes those affected have the feeling that their teeth are loose. Biting on hard foods such as apples, raw carrots or nuts is difficult. But: “Diabetes and periodontitis are often only recognized at an advanced stage,” Deschner explains. “That’s why every diabetic should have their teeth checked regularly. And vice versa, one or the other dental practice has discovered diabetes.”
Diabetics, whether type 1 or type 2, suffer from periodontitis more often than people who have no problems with blood sugar. The risk is sometimes several times higher. Periodontitis is also more severe, and diabetics lose more teeth than people without diabetes.
Docking sites for insulin blocked
This is shown by a study from Mecklenburg-Western Pomerania, in which researchers examined the oral health of 3,300 diabetes patients. Deschner: “Type 2 diabetics with poorly controlled blood sugar had to have their teeth pulled twice as often as those with good blood sugar levels. The value was even higher for type 1 diabetics.”
Pathological changes in the gums and oral mucosa also occurred significantly more frequently. “In general, diabetics are more susceptible to infections, their wounds heal less well. Unfortunately, this also affects teeth and gums.” Doctors have not known for very long that periodontitis in turn influences the course of diabetes. Studies now confirm that blood sugar levels deteriorate. Therapies, be it with insulin or other medication, do not work so well. “Complications from diabetes, such as those affecting the kidneys, cardiovascular system or eyes, also occur more frequently,” reports Deschner. The explanation: The inflammation in periodontitis permanently blocks the areas where insulin acts. As a result, the sugar circulating in the blood cannot be absorbed and stored in body cells.
Although the body usually produces enough insulin in type 2 diabetes, it cannot work in the right places. This phenomenon is called insulin resistance. Unfortunately, mouth and teeth also influence the blood sugar situation of non-diabetics in the long term. Periodontitis increases the risk that your blood sugar levels will deteriorate and that diabetes will develop later.
Therapy is not only worthwhile for the mouth
But there is also good news: People with diabetes benefit from periodontitis therapy. Successful treatment can lower elevated blood sugar levels. Analyzes have shown that dental treatment of periodontitis in type 2 diabetics has a positive effect on metabolic control and the diabetes can therefore be better controlled. If the diabetes is well controlled, there is no increased risk and the response to periodontitis treatment is just as good as that of non-diabetics.