Those with uncontrolled or poor-controlled diabetics may experience a burning sensation in the mouth or tongue due to a reduced salivary flow.  There may also be an increased risk to tooth decay and fungal infections.

How is periodontitis treated in a diabetic patient?

The Periodontist (dental surgeon who specializes in gum disease) needs a certain amount of medical information such as the patient’s blood sugar level and the type of medication he/she is on.  Treatment may need to be modified according to the medication the patient is on and how well the diabetes is controlled.

A well-controlled diabetic is usually treated similar to a non-diabetic with periodontal disease unless there are other medical conditions present.  Patients are instructed to take their medications as perscribed and eat a normal breakfast.  Early morning appointments are preferred as a certain type of hormone that reduces stress is in greater quantities in the morning.

A poorly-controlled diabetic will be treated in collaboration with his/her doctor or endorinologist.  Gum treatment is still encouraged though these patients may not respond as well as well-controlled diabetics.  Early studies in the United States suggest that controlling periodontitis in the poorly-controlled diabetics may contribute to better blood sugar control.

In general, gum treatment consists of multiple sessions of deep scaling beneath the gums usually with local anaesthetic.  In certain cases, surgical treatment may be recommended.  Periodontal treatment may also be combined with treatment from other dental specialities especially if replacement of lost teeth is required.

What should I do to keep my oral health optimal at all times?

Prevention is always best.  Once periodontitis occurs, the amount of bone supporting the teeth that is lost cannot be regained.  Periodontal treatment will control the disease and helping the prevention of tooth loss buy may not fully correct the receded gums or lessen the looseness of teeth that has already occurred.

Optimal oral health can be achieved via:

1. Good control of diabetes via medication, diet, exercise as advised by the doctor.
2. Regular dental check ups that include gum checks and X rays.
3. Regular periodontal maintenance by a dentist or periodontist for patients who have had gum disease.
4. Good personal oral hygiene or home care.  Efficient tooth brushing and flossing techniques should be learned from the dentist or periodontist.

What is periodontitis?

Periodontal disease, more commonly called gum disease, is a chronic (long-standing) bacterial infection of the gums.  It is caused by plaque, which is a stickly, colourless or slightly yellow layer that accumulates on teeth.  In the early stage of the gum disease called gingivitis, the bacteria in plaque produces toxins (poisons) that leads to red and swollen gums.  As the disease progresses to periodontitis, the toxins destroy the bone supporting the teeth.  Although there is little pain in the early stages of periodontitis, gum swellings, pain and loosening of teeth may develop later.

How will I know if I have gum disease?

The following are some signs of gum disease:

• Red and bleeding gums
• Swollen and receding gums
• Bad breath
• Spaces appearing between teeth
• Loosening and shifting of teeth
• Vague itchiness or ache in the gums

How does having diabetes affect my gums?

In diabetic patients, the white blood cells (which protect against infection) are defective.  The amount of collagen necessary for healthy gums and good healing capacity are also reduced.  This is worse in poorly-controlled diabetics.  Hence, poorly-controlled diabetics have a poor healing capacity and an increased risk to periodontitis.  Periodontitis is also more severe in diabetics with more advanced diabetic complications and in those who have had diabetes for a longer time.

Well-controlled diabetics have a lesser risk to periodontitis compared to poorly-controlled diabetics.

Teeth are not naturally pure white.  The colour of our teeth is determined by the composite colour of all the structures that make up the tooth (the outer layer of enamel, the inner layer of dentine as well as the pulp which contains the nerve) and how light is absorbed and reflected off these structures.

Enamel is whiter, while dentine has a naturally yellow tinge.  There is also a natural gradation of colour in the teeth – darker nearer the gum margin and lighter at the tip of the teeth.  This variation is affected by the thickness and translucency of the enamel and dentine.  Typically, the canines at the corner of the mouth are darker than the front teeth and teeth also tend to become darker with age due to wear.

Some common factors influencing the colour of your teeth include………. read about it at Healthy Times Magazine.

Learn also steps on “How To Bleach” your teeth and if Home Bleaching, In-operatory bleaching or Non-vital bleaching is more suitable suitable for you.

Before even consider bleaching your teeth, find out the main complications of teeth bleaching and ……….. more information available at Healthy Times Magazine.

Most of the time, periodontal disease occurs due to neglect or ignorance. To prevent gingivitis and periodontitis, the following has to be done by the patient.

1. Use a soft or extra soft toothbrush.
2. Follow the dentist’s recommendation of an efficient way of brushing twice a day. The most common
   efficient technique used is the Bass technique.
3. Floss once a day or use other interdental aids if unable to floss.
4. Go for regular professional cleanings to get rid of any calculus that has formed under the gum line.

Remember, a good set of teeth goes a long way, not only to your self-confidence but also to your health.  Do take care of your teeth by brushing regularly and visiting your dentist for regular check-ups.

Till then……do check me out at my Gum Disease Information Lens where I talk more in detail about gum disease ….I’d love to hear from you.

Dr Yasmin Akrum, Periodontist, Gum Specialist Singapore