INTRODUCTION
There is one type of food that is consumed more than almost any other ingredient in the United States—sugar! While sugar isn’t inherently a problematic ingredient to consume, sugar can cause some negative health consequences (Gager, 2018). A lot of people know that consuming too much sugar can increase their susceptibility to developing diabetes and other health conditions. Most people also know that eating too much sugar can increase their likelihood of developing cavities on their teeth and other periodontal diseases. But one thing that most people don’t realize is that diabetes and periodontitis have a very specific relationship to each other. Before I discuss the relationship between diabetes and periodontitis, you might want to know a little about each.
WHAT IS DIABETES?
First off, what is diabetes? According to the Centers for Disease Control and Prevention (CDC), diabetes is a chronic condition that impacts the way that the body turns food into energy. Most of the foods that we eat get broken down into sugar and is released into the bloodstream. Insulin is an important hormone that regulates the blood sugar levels in the body. When a person has diabetes, their bodies either do not produce enough insulin or are unable to utilize insulin to regulate the body’s blood sugar levels (Centers for Disease Control and Prevention, 2021).
WHAT IS PERIODONTITIS?
Most people have heard of periodontitis, but what does that really mean? Periodontitis is a disease of the gums and bone that surround the teeth. As the disease progresses, the gums pull away from the tooth, the bone surrounding the teeth starts to deteriorate, and there may be tooth mobility or even the loss of teeth due to periodontitis. Periodontitis is present in almost 50% of adults in America over age 30 (Centers for Disease Control and Prevention, 2013).
DIABETES AND PERIODONTITIS
Now that you know a little bit about diabetes and periodontitis, you may be wondering how the two conditions relate to each other. Diabetes is a systemic disease which impairs the body’s immune system and causes decreased wound healing. When the bacteria involved in periodontal disease starts to “eat away” at the gums and bones in the oral cavity, a person with diabetes will have a lessened ability to defend itself from the attacking disease (AlShwaimi, et al., 2018). In 2018, a study was conducted that tested the glucose metabolism in pre-diabetic patients and diabetic patients compared to the changes in the periodontal microbiome. The study found that patients with poorly controlled diabetes exhibited signs of more aggressive periodontitis than patients with controlled diabetes. It also concluded that periodontitis may affect diabetes control, but successful treatment of periodontitis may not be helpful in controlling diabetes (Polak & Shapira, 2018).
Another study was conducted as a randomized controlled trial and found that diabetes and periodontitis may go hand-in-hand. A person with diabetes mellitus will have an increased risk of developing periodontitis because their body's weaker immune system and increased susceptibility to disease. Additionally, a person who has chronic periodontitis has an increased risk of developing diabetes mellitus because periodontal disease may cause an increase in glycogen levels in the body (Sakka, 2020).
After establishing and understanding the relationship between diabetes and periodontitis, the scientific community began to wonder if the treatments of each condition had a similar relationship. A study was then conducted to update existing evidence regarding epidemiology and the relationship between diabetes and periodontitis, and to examine the impact of periodontal therapy upon the control of diabetes. The study found that there is a strong correlation between periodontitis, increased glycogen levels, and insulin resistance. It also found that controlling diabetes is effective in the reduction of periodontal disease. However, the results from using periodontal therapy to help control diabetes came back inconclusive (Sanz, et al., 2018).
CONCLUSION
So, regardless of if you have diabetes or periodontitis, it is good to know the implications of each. While diabetic patients are more likely to develop periodontal disease than a non-diabetic patient, anyone can develop periodontitis from poor oral hygiene and other various causes, so it is helpful to realize the need for effective treatment and good habits. When you recognize the need for treatment early in the process of any disease, it is much easier to stop the disease process and get back to a state of health. The end goal for any dental hygienist is to get their patients back to a state of health, and one of the main ways we can do this is by educating our patients about what the problem is, what treatment is available, and how to stay healthy after treatment is complete.
CITATIONS
AlShwaimi, E., Idrees, M., Berri, Z., El-Sakka, H., & Kujan, O. (2018, November 29). Association
between diabetes mellitus and periodontal diseases: A survey of the opinions of Dental
Professionals. Medical Principles and Practice. Retrieved April 12, 2022, from
https://www.karger.com/Article/Fulltext/495881
Centers for Disease Control and Prevention. (2021, December 16). What is diabetes? Retrieved
April 12, 2022, from https://www.cdc.gov/diabetes/basics/diabetes.html
Centers for Disease Control and Prevention. (2013, July 10). Periodontal disease. Retrieved April
12, 2022, from https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html
Gager, E. (2018). Finding the hidden sugar in the foods you eat. Johns Hopkins Medicine.
Retrieved April 12, 2022, from https://www.hopkinsmedicine.org/health/wellness-and-
prevention/finding-the-hidden-sugar-in-the-foods-you-eat
Polak, D., & Shapira, L. (2018). An update on the evidence for pathogenic mechanisms that may
link periodontitis and diabetes. Journal of Clinical Periodontology, 45(2), 150–166.
https://doi-org.ezproxy.aclin.org/10.1111/jcpe.12803
Sakka, S. (2020). Periodontal Disease and Diabetes Mellitus. An Insight into Their Interrelated
Health Implications. International Journal of Medical Dentistry, 24(3), 343–349.
https://ijmd.ro/2020/periodontal-disease-and-diabetes-mellitus-an-insight-into-their-
interrelated-health-implications/
Sanz, M., Ceriello, A., Buysschaert, M., Chapple, I., Demmer, R. T., Graziani, F., Herrera, D.,
Jepsen, S., Lione, L., Madianos, P., Mathur, M., Montanya, E., Shapira, L., Tonetti, M., &
Vegh, D. (2018). Scientific evidence on the links between periodontal diseases and diabetes:
Consensus report and guidelines of the joint workshop on periodontal diseases and diabetes
by the International Diabetes Federation and the European Federation of Periodontology.
Journal of Clinical Periodontology, 45(2), 138–149. https://doi-
org.ezproxy.aclin.org/10.1111/jcpe.12808
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