Menacing duo Diabetes and periodontitis - a dangerous combination

Periodontitis and diabetes promote tooth loss and mortality

About eleven million people in Germany suffer from inflammation of the periodontium requiring treatment. Such periodontitis has particularly serious consequences for diabetic patients, because these two diseases have dangerous interactions, as the German Diabetes Association reports. On the one hand, type 1 and 2 diabetes are three times more likely to develop periodontitis, and secondly, the presence of periodontal disease worsens blood sugar levels.

According to the German Diabetes Society (DDG), periodontitis is the most common chronic disease worldwide. Bacterial plaque is the main trigger for the inflammation of the periodontium. The DDG recommends a particularly careful oral hygiene to all diabetic patients and recommends regular dental checks. Furthermore, according to the DDG recommendation, diabetics must pay close attention to the blood sugar control in order to minimize the risk of periodontitis.

Periodontal disease occurs as a result of bacterial plaque, which only causes superficial inflammation, which can spread over time to periodontal disease, which in turn can lead to tooth loss. (Image: Michael Tieck / fotolia.com)

How does periodontitis develop?

In the vernacular, periodontitis is often mistakenly called periodontal disease. In the disease, the bacterial plaque causes gingivitis (superficial inflammation of the gums). Left untreated, this can lead to periodontitis. "In addition to poor oral hygiene, smoking, stress and genetic factors are the causes of this chronic inflammation," explains Professor. med. Dirk Müller-Wieland, President of the DDG in a press release. In addition, diabetes mellitus is another major risk factor.

Diabetes promotes periodontitis

"If the blood sugar level of the diabetic patient is poorly adjusted, the risk of periodontitis increases sharply," says Müller-Wieland. But that is not how it remains. The two diseases have dangerous interactions. The professor also reports that gum treatment becomes more complicated when both diseases are present. In addition, the disease is more severe and tooth loss is more common.

Periodontitis worsens diabetes course

The presence of inflammation of the periodontium in turn has an unfavorable effect on the blood sugar control. "With the depth of the periodontal pockets, the long-term blood glucose level also increases," explain the DDG experts. It has already been established in studies that even the mortality of diabetic patients with periodontal disease is higher than in people with a healthy mouth. One reason for this is seen in the negative effects of inflammatory processes on heart health.

Periodontitis is often overlooked for a long time

A common problem in diagnosing periodontitis is that it causes mostly no pain and thus there is no great trade pressure on the part of the patients. "It is therefore important to pay attention to first warning signs such as bleeding gums, swollen gums, bad breath, changes in the tooth position or longer, loose teeth," advises DDG expert Dr. med. med. Erhard Siegel. Regular dental examinations can minimize this risk.

Recognize early forms of periodontitis

The dentist's screening test using the so-called "Periodontal Screening Index" (PSI) can already detect early disease stages of periodontitis. These can be treated much better, according to DDG. "Especially people with diabetes should go to the dentist at least once a year for control," recommends dental technician Siegel.

They can do that themselves

Furthermore, the DDG doctors recommend giving up smoking, to ensure a healthy and balanced diet, to avoid or reduce overweight and stress. Stress reduction methods can counteract inflammation.

Self-test for the first assessment

The German Society for Periodontology (DG Paro) has developed a self-test together with the University of Greifswald, with which everyone at home can assess their own risk for the presence of periodontitis. Factors such as age, gender, smoking status, the presence of bleeding gums and the strength of teeth play a role. The self-test can be done for free on the DDG website.

Doctors should be more sensitive to the topic

"Diabetologists, house doctors and dentists should also be increasingly sensitized to this topic," says Müller-Wieland. In Germany there are about two million people who do not know that they have diabetes. Consequently, these individuals would also know nothing about their increased risk of periodontitis. The education on this subject must also take place more in all participating specialist practices.

New guideline to improve prophylaxis

"For example, screening measures such as a diabetes test in dental practices or the inclusion of dental status in the family medical history could ensure better prevention of periodontitis," said Siegel. Currently, a new guideline "Diabetes and Periodontitis" is in progress. This should provide important information about the interactions between the two diseases and provide specific recommendations for care and early detection. (Vb)