Certain conditions or diseases affect the development or advancement of gum disease. More specific information may be helpful to understand the conditions and alternatives of care.
Information is available linking gum disease to:
Diabetes Heart Disease Pulmonary Disease
Diabetes
What is Diabetes?
Diabetes mellitus is a group of disorders that display glucose intolerance or impaired lipid or carbohydrate metabolism. It is a result of a deficiency in insulin production or usage. There are 2 main types, Type I which used to be called insulin dependent and Type 2 which used to be called non-insulin dependent. Recent changes in the classification of diabetes has gone to one following etiology not the drugs necessary to threat it. For more information about this contact the American Diabetes Association. About 12 million people in the United States have diabetes. Most of these are Type 2.
How do you get Diabetes?
Type I is caused by destructions of the insulin producing cells in the pancreas. This can be the result of an autoimmune process or a viral infection. Some people are genetically predisposed to this process. The onset is often abrupt and may be difficult to control.
Type 2 is caused by defects in the insulin molecule produced or a resistance to insulin resulting in decreased insulin function. The onset is normally gradual and patients are often obese and improvement will occur if diet and body weight are controlled.
Symptoms
Weakness, fatigue, thirsty and frequent urination are symptoms. Occasionally, irritability, restlessness and apathy appear. Symptoms can be helped by proper treatment. Diminished saliva flow and burning tongue or mouth are often seen in diabetic patients. The dry mouth can lead to opportunistic oral infections.
Diabetes and Gum Disease
Type 1 patients have an increased risk of developing periodontal disease and this increases with age the length of time the patient has been diabetic. Type 2 diabetes patients are almost 3 times more likely to have periodontal disease. Periodontists now consider diabetes a risk factor for periodontitis. Poorly controlled diabetic patients display worsening periodontal disease.
This increase in gum disease is due to several factors, some of which we cover here. One of these is the reduced host resistance due to a decrease in the function of polymorphonuclear leukocyte, one of the protective white blood cells in our blood stream. These cells normally crawl to bacteria, stick to them and help kill them, but in diabetic patients all these actions can be diminished. Another factor is seen in collagen synthesis, maturation and homeostasis which is altered by glucose levels. Collagen is a building block of bone and tissue including the gums. Gingival capillaries in diabetic patients are thicker and this affects the distribution of precious oxygen to the cells in the gums(as well as the rest of the body).
The above factors lead to an increase susceptibility to infections including gum disease. Diabetic patients get changes in the bacteria that like to live under the gum, to several types that are more likely to cause problems. These factors also affect the ability to heal properly. This includes healing from wounds and infections and from periodontal treatment. Therefore, diabetic patients need to monitor their control better when healing. This may include closer contact with the physician for additionally support during these times.
The coin here has two sides as gum disease can affect the ability to keep the diabetes under control. Diabetic patients with severe gum disease were compared to some with only mild gum disease. Those with the severe disease over the next decade had more heart disease, strokes, heart attacks and angina than those with only mild gum disease. That is more reason to control the gum disease in diabetic patients. It is also harder to keep the gum disease under control in poorly controlled diabetic patients.
Heart Disease
People with heart disease must be more concerned about having gum disease since recent link between the two has been established. More research is indicated, and to hear it from the horses mouth visit the AAP website, www.perio.org/consumer/webcardio.htm which describes the relationship.
We know already that smoking, being overweight, high cholesterol and high blood pressure are risk factors for heart disease. It is becoming more evident that periodontal disease may double the risk of heart disease.
Periodontal disease is a bacterial infection and the bacteria can enter the bloodstream. These bacteria can attach to the fatty deposits that build up in the coronary arteries and contribute to clot formation. When these coronary arteries fill up with fatty deposits, the flow of blood to the muscle of the heart is limited causing a lack of nutrition and oxygen to the heart. This can eventually result in heart attack.
Some patient with existing heart conditions are also at risk. Rheumatic fever, mitral valve prolapse and heart murmurs take antibiotics prior to dental visits to help prevent infections in the heart. If you have one of these conditions, contact your physician and find out if you should be taking this precaution. Or check with us and we can help you in this process.
Another concern to your gums are the medicines used to treat high blood pressure and heart disease. some of these cause dry mouth, thickening of the gums or increased bacterial plaque. This can lead to bad breath, bleeding gums and gum disease. Bring a list of your medications with you and we can discuss these concerns at your consultation.
Pulmonary Disease
Periodontal disease is caused by bacteria in the mouth. These bacteria produce toxic products that can work their way into the lungs and cause aggravate pulmonary conditions.
Patients with chronic pulmonary conditions must be concerned that their mouths are healthy so as not to aggravate already dangerous breathing conditions with the toxic products and bacteria involved with gum disease.
