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<H3> Diabetes and gum disease can go hand-in-hand. Managing either condition involves managing the other equally well.</H3> <P>Over the last several decades, much progress has been made in both dental care and diabetic care. <P>The life expectancy of diabetic patients has been prolonged as a result, and so has the life expectancy of their teeth. <P>In the past adults lost most of their teeth in early to middle age; there are now significant numbers of people who are retaining most or all of their teeth all of their lives. <P>Diabetics are more prone to oral infections, and are less likely to show signs and symptoms before they're serious. <CENTER> <TABLE CELLSPACING=0 CELLPADDING=0 BORDER=0 WIDTH="85%" ALIGN=CENTER> <TR><TD ALIGN=LEFT> "Periodontal diseases are the sixth leading complications of diabetes. Studies show that diabetic patients are up to 4.2 times more likely to develop periodontal diseases than those without diabetes. This is probably because diabetic patients are more susceptible to contracting infections. Research suggests that the relationship between periodontal diseases and diabetes goes both ways - periodontal diseases may make it more difficult for people who have diabetes to control blood sugar." </TD></TR> <TR><TD ALIGN=RIGHT> <B>"Diabetes and <BR>Periodontal Diseases: <BR>A Two-Way Street" <BR>The American Academy of Periodontology</B> </TD></TR> </TABLE> </CENTER> <P>The fact is, poor control of your diabetes is one more price a person with diabetes pays for dental neglect. <P>Brittle diabetes affects not only the quality of a patient's dental health, but the quality of their whole life. Don't you owe it to yourself to make that life the best it can be? <P>The most important first step a diabetic patient can take to prevent tooth and gum problems is to control your blood glucose. Otherwise, diabetic patients are much more vulnerable to infection. Period. <P>Other important keys to preventing problems include regular checkups, at least twice a year, especially if your gums bleed or you notice unusual changes in your mouth, such as whitish-colored skin; effective plaque removal; good home oral hygiene; and openly discussing your diabetes and its treatment with your dentist. <P>When seeking treatment, diabetic patients may want to choose dentists, periodontists and endodontists who have made this area of dentistry a specialty. <P>Practitioners with more experience treating diabetes can make a number of special accommodations for patients, and can use specialized testing, procedures and equipment for diagnosis and treatment. <CENTER> <TABLE CELLSPACING=0 CELLPADDING=0 BORDER=0 WIDTH="85%" ALIGN=CENTER> <TR><TD ALIGN=LEFT> "For diabetics, the key issue is that dental treatment plans, other than emergency care, should be delayed if the patient's diabetes is uncontrolled... If managed properly, adults with Type 2 diabetes can become good long-term dental patients, but extra care in patient management may be helpful. These precautions include: 1) efforts to reduce any factors that might cause stress, apprehension or pain during a dental visit; 2) appointment times that are early in the day when the patient is rested; and 3) special instructions to diabetic patients to remember to have breakfast and take their medications before each dental appointment. The administration of prophylactic antibiotics before routine dental visits is usually not necessary for controlled diabetic patients if these appointment procedures are followed." </TD></TR> <TR><TD ALIGN=RIGHT> <B><A HREF="http://www.colgateprofessional.com/cp/copocr.class/ocr/repository/article-1/frameset.jsp?middle=issue_update2.html" TARGET="_blank">"Diabetes and Periodontal Disease"</A> <BR>by Chester W. Douglass, DMD, PhD <BR><I>The Colgate Oral Care Report</I> <BR>Volume 12, Number 1 </TD></TR> </TABLE> </CENTER> <P>The complete dental caries and periodontal exam should include: analysis for plaque, inflammation of the gums, perio pockets, bone loss, tooth mobility, and application of pressure around each and every tooth, to see if pus or discharge occurs. Patients can have normal-looking gums, and yet have infection lurking beneath them. <P>Diabetic patients should also be examined for oral lesions or cancer, and for such conditions as dry mouth, lupus, scleroderma and jaw arthritis. If you have dental devices, they should also be evaluated for proper fit. <P>Testing for periodontal problems now includes a battery of laboratory methods in addition to what your dental practitioner can observe. <P>With any practitioner, ask all the questions you need to about the steps and complexity of the procedures, before they're done. If the patient has a glucose testing device, it might be helpful to bring your glucose testing device for on-the-spot checks of your sugar level as the procedure is carried out. <P>If gum surgery is required and your diabetes is poorly controlled, having it done in a hospital may allow more complete and constant monitoring of postoperative blood sugar levels. <P>When undergoing any extended treatment, don't try to be a hero or heroine. Acute stress, including the stress of pain, can interfere with metabolism. Ask about stress and anxiety-reducing methods ahead of time, so you can begin to practice them. <P>Diabetic patients must realize that they are more prone to periodontal disease and the problems it can cause. <P>By following the basic principles of prevention, from a good program of daily oral hygiene to frequent dental check ups and proper treatment as needed, patients are certain to minimize their risks and maximize their quality of life. And isn't that the ultimate goal? <P>The American Academy of Periodontology has more information about the connection between diabetes and gum problems. Click on this link to their Internet site: <P> <LI><A HREF="http://www.perio.org/consumer/mbc.diabetes.htm" TARGET="_blank"> The American Academy of Periodontology</A> <P>An expanded discussion of this topic is included in the pamphlet "What Diabetics Should Know About Dental Health,'' available from Dr. Morton.
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