Gum Disease May Make Diabetes Worse
Researchers Say Good Oral Hygiene Is Important for Controlling Type 2 Diabetes
June 6, 2008 -- Taking care of your gums may be one of the best things you
can do for your health if you have diabetes.
Poorly controlled diabetes has long been recognized as a major risk factor
for gum disease, but there is a growing body of research suggesting that
untreated gum disease, in turn, makes diabetes worse.
"It is definitely a two-way street," says Stony Brook University
professor of oral biology and pathology Maria E. Ryan, DDS, PhD. "If there
is oral infection and inflammation, as with any infection, it is much more
difficult to control blood glucose levels."
Ryan summarized the research on gum disease and type 2 diabetes in a
symposium at the 68th annual scientific session of the American Diabetes
Association (ADA) in San Francisco.
Many Unaware of Gum Disease-Diabetes Link
Ryan tells WebMD that health care providers who treat type 2 diabetes are
only now beginning to recognize the importance of good oral hygiene for
controlling the disease.
American Diabetes Association Vice President of Clinical Affairs Sue
Kirkman, MD, agrees.
"This is definitely something the diabetes community needs to know more
about," Kirkman tells WebMD. "It is now clear that periodontal disease
can make diabetes control worse, and there is even some evidence that it
increases the risk for diabetes complications."
Those complications include heart disease, blindness, kidney disease, and
Nearly 21 million Americans have diabetes, and it is believed that nearly a
third have severe gum disease with significant loss of gum attachment to the
Bleeding gums are a sign of periodontal disease, but infection and
inflammation often occur with no visible signs of trouble.
"[Gum] disease is often silent," Ryan says. "This is especially
true for smokers, who often have significant inflammation with no
In her presentation at the ADA meeting, Ryan reported on an unpublished
study she conducted with colleagues from Stony Brook University suggesting a
direct correlation between insulin sensitivity and severity of gum disease in
people with prediabetes.
The suggestion from the study is that treating gum disease could actually
slow down the progression to diabetes in those at high risk of developing the
Previously reported research in a population of American Indians with very
high rates of type 2 diabetes showed gum disease to be a strong predictor of
death from diabetes or heart disease -- independent of other risk factors.
Treating gum disease has also been shown to have a positive impact on blood
sugar and diabetes control in other studies.
Doctors Should Ask About Teeth
So how does gum disease affect blood sugar control and diabetes?
One theory is that chemicals produced when gums are inflamed enter the
bloodstream through the gums and stimulate cells to become insulin resistant,
Whatever the mechanism, Ryan says people with type 2 diabetes -- and anyone
at risk for developing the disease -- should have regular dental exams.
And clinicians who treat people with diabetes need to keep gum disease on
their radar screens.
"We aren't suggesting that physicians examine patients for oral disease
because you can't really tell just by looking in someone's mouth," Ryan
says. "But every diabetic should be asked if they have seen a dentist
within the last year. If they haven't, they should definitely make an