After more than 30 professional years researching, writing about, and managing my own blood sugar imbalance, I still believe gum care is among the most important and least appreciated aspects of self-management for diabetes, metabolic and insulin resistance syndromes, and many immune system disorders. Studies keep showing how gum disease (periodontal infection) and diabetes are a reflection of each.
Severe gum disease (periodontitis) is known to actually be a major contributing factor in diabetes. According to researchers at Marquette University, “Periodontitis raises levels of inflammatory cytokines and serum lipids—these cytokines can produce an insulin resistance syndrome similar to that observed in diabetes and initiate destruction of pancreatic beta cells leading to development of diabetes.
Just as gum disease contributes to diabetes, having diabetes worsens gum conditions. According to the American Academy of Periodontology (AAP), “Periodontal disease is often considered the sixth complication of diabetes. Those people who don’t have their diabetes under control are especially at risk.” The link between diabetes and gum disease is that both cause inflammation, not just locally, but throughout the entire body. Inflammatory cytokines like interleukin 1 (IL-1) and tumor necrosis factor (TNF) inflame blood vessels, creating small scars—soon the vessels block up with plaque. These blockages are linked with heart and kidney disease, strokes, and all major complications of diabetes.
A study from Bangalore, India looked at 200 people—half of whom had recent strokes or heart attacks. Researchers controlled for family history of stroke, diet, smoking and alcohol consumption, diabetes, hypertension, total serum cholesterol level, and education level. Those with worse gums (pocket depths greater than 4.5 millimeters) had far higher risk of strokes and other cardiac events.
Along with inflammation, infection of the gums creates a vicious diabetes circle—gum infections can raise blood glucose levels. At the same time, high blood glucose makes it harder to fight infections. High glucose seems to weaken white blood cells called “neutrophils,” so they can’t kill germs as effectively. And one more thing…the latest research indicates that gum disease is a major risk factor for erectile dysfunction (ED), very common in men with diabetes—improving gum health may actually cause erections to return.
Diagnosing Gum Disease
The National Diabetes Information Clearinghouse lists seven possible symptoms of gum disease. These include:
- red, sore, swollen gums;
- bleeding gums;
- gums pulling away from your teeth so your teeth look long;
- loose or sensitive teeth;
- bad breath and/or dry mouth or excessive thirst;
- a bite that feels different;
- dentures—dental restorations—that are not a good fit.
If you have any of the above symptoms, you should see a dentist or periodontist (dentist specializing in gum diseases) right away. My research and clinical experience shows it’s best to seek a dentist who is trained and certified in dental laser procedures for periodontal surgery as it’s so much less invasive than cutting the tissues, and the healing is fast—lessening the chance of a secondary infection, especially in diabetics. And… keep in mind that diabetes means you are more likely to have gum disease, even without symptoms.
What Can You Do?
Ninety percent of dental care is self-care. The most important thing is to brush, floss, and rinse with antiseptic mouth rinse at least once a day, preferably more. I personally use and recommend a proprietary blend mouthwash made from organic essential oils, peroxide and colloidal silver because it has no coloring or additives and actually reduces inflammation and bacteria without adding insult to injury with chemicals. As described by its formulator, Elizabeth Bloom of Elizabeth Essentials, “Mouthwash Essentials helps to maintain healthy oral health as well as guard against infection. Since it’s naturally enriched with essential oils known for centuries to boost immune responses, why would you use chemicals?”
According to Jenny Ruhl at Diabetes Update, “If at first your gums bleed a lot or are painful, keep at it, over time they should toughen up and get healthier and bleeding will stop.”
But professional dental care is also super-important. According to The Gum Disease—Diabetes Project, gum disease causes “pockets” that are much deeper than the normal gap between tooth and gum. When this happens, you can no longer reach into the pocket with floss or a toothbrush, so it’s hard to get the germs out, although small interproximal brushes sometimes help. That’s where professional help comes in. Once those pockets become so deep that even a hygienist cannot sufficiently clean them, it’s time for serious periodontal treatment—deep scaling and laser surgery being great alternatives to cutting all the gum tissues!
Researchers at University of Buffalo (UB) found, “Elimination of periodontal infection and reduction of periodontal inflammation in diabetic patients resulted in a significant short-term reduction in the concentration of glycosylated hemoglobin (HbA1c).”
Another UB report found that simple tooth cleaning is not enough for most people with diabetes. Antibiotics are often recommended by the dentist for a bacterial infection but can serve to cause other serious issues like knocking the immune system down another notch and the opportunity for a serious yeast infection as all the bacteria is killed—the good and the bad. There are other natural immune enhancers like a homeopathic silver hydrosol that acts like an antibiotic that can be used to rinse and also take orally. See your integrative or natural health care provider as this product is not available over-the-counter. The treatment of chronic periodontal infection is essential in the diabetic patient.
The AAP cites another study of Pima Indians with both diabetes and gum disease. This study found, “When their periodontal infections were treated, the management of their diabetes markedly improved.”
Good oral health is much more than brushing, flossing, and supplementing with calcium, vitamins D and C. Studies indicate omega-3 fats help calm oral inflammation caused by infections—not to mention the overall benefit for widespread inflammation throughout the body and the effects of health-depleting oral bacteria on blood sugar.
Why? Diabetes makes the body more susceptible to bacterial infection, so people with diabetes have a decreased ability to fight germs that invade the gums. Fortunately, there are easy steps you can take to protect your oral health if you have diabetes.
According to the National Diabetes Education Program (NDEP), cardiovascular disease is the leading cause of death among people with diabetes. About 68 percent of diabetics die of heart disease or stroke. In fact, researchers discovered that obtaining near-normal glucose control with drug therapy is associated with “significantly increased risks of death from any cause and death from cardiovascular causes”—the very outcomes the medication was supposed to prevent.
A recent meta-analysis of 13 randomized controlled trials concluded: Not only is drug treatment to lower blood glucose levels ineffective... it’s also dangerous.
The Way I See It…
The problem with the glucose-lowering drugs is this...they don’t address the underlying causes of inflammation, which contribute to cardiovascular disease—they simply lower blood sugar, and, when it comes to fighting heart disease, they are often not effective and can be dangerous.