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Periodontal disease aka periodontitis in diabetes

High blood sugar predisposes a person to an infection of the attachment tissues of the teeth. On the other hand, an oral infection raises blood sugar.

In the image is a mouth with and active perodontitis, where connective tissues and bone that keep the teeth attached are destroyed, making the teeth wobbly. Image: The Finnish Dental Association.
In periodontal disease, the connective tissues and bone that keep the teeth attached are destroyed, making the teeth wobbly. Image: The Finnish Dental Association.

A periodontal disease is an inflammatory disease of the mouth resulting from bacteria. The inflammation destroys the connective tissues keeping the teeth in place as well as bone. In this case, you talk about a disease of the soft and bone tissues supporting the teeth. The medical term for it is periodontitis. Periodontitis is very commonplace in Finland.

The infection of the soft tissue is normally painless, and its only symptom is bleeding gums. The gums can be red and swollen. The infection can be visible as gaps appearing between the teeth or the dental arch changing shape. The condition can remain asymptomatic so long that tooth loss becomes a possibility.

The commercially available Periosafe® quick test can detect an infection of the supporting tissue of the teeth based on the enzymes in saliva. The test does not replace an oral examination. It identifies people who need treatment. After a positive result, you should immediately have further examinations and treatment.

If you have diabetes and your blood sugar is high, the infection is more severe and the tissue loss can accelerate. A person with diabetes has a 2–4 higher risk of severe periodintitis. The infection progresses undetected under the gum and it can cause so much tissue loss that it is necessary to remove teeth.

Smoking reduces the flow of blood in the gums, increasing the risk and severity of periodontitis and slowing down the healing process, even if the film of bacteria is removed. Quitting smoking is of the utmost importance. Dental care professionals can offer support with cutting down or quitting.

High blood sugar increases the risk of infection in the mouth and, vice versa, a mouth infection increases the blood sugar level. Due to this two-way effect and the fact that the disease is so hard to detect, it is very important to have your mouth regularly checked and treat the infection properly.

In addition to taking good care of blood sugar, you should intensify your self-care and remove plaque mechanically to prevent and treat periodontitis. You should brush your teeth twice a day and floss between your teeth regularly. If the film of bacteria is not removed, it will harden into tartar which, especially if it forms under the gum, can cause an infection that damages the attachment tissue. The essential thing is to remove tartar and the film of bacteria from the surface of the roots of the teeth, especially under the gum.

A dentist can check the attachment tissues of the teeth by measuring the gingival pockets in connection with the examination of the mouth. The teeth should be x-rayed to determine any potential loss of attachment tissue. Based on the findings, the dentist can come up with a care plan together with you and instruct you on oral self-care.

If the disease is at a mild state, a dental hygienist can clean the gingival pockets but, as the disease progresses, a dentist or specialist dentist will take over the treatment.

Updated 8.11.2023