Periodontist's Role and Diagnosing Diabetes

Yesterday we discussed Periodontal Therapy for the Diabetic Patient. Today we talk about the role of Dr. Versman and Dr. Heller at Periodontal Associates, in addition to dentists in general, and their ability to play a favorable role in detecting diabetes. 

Through observation of our patients' soft tissue response to periodontal therapy, dentists are in an ideal position to detect alterations which may result in an earlier diagnosis of diabetes.

In addition to the basic diagnostic tools for periodontitis, analysis of subgingival bacteria is another important diagnostic tool for the extended management of periodontal disease in diabetics. Subgingival cultures are frequently helpful in identifying these pathogens.

Recognizing other unexpected soft issue treatment response patterns may also lead to the discovery of diabetes, including dry mouth, and sporadic, aching pain in the lower anterior teeth without apparent cause.

It is best to treat controlled, insulin-dependent diabetic patients about 90 minutes after a meal and insulin dose. Ordinarily, this would be mid-morning to allow blood sugar levels to drop and to reduce the risk of diabetic complications during treatment. In addition to an appropriate postoperative diet, diabetic patients usually require antibiotics concomitant with treatment due to their lowered resistance to infection. The diabetic patient requires close monitoring the shorter maintenance intervals. Because glucose concentrations in diabetics are elevated in gingival fluid and saliva, the diabetic patient with root exposure has a substantially increased incidence of root caries. Fluoride rinses, gels or NaF varnishes may be helpful.

Initiating periodontal care for the diabetic patient should be a foremost concern of physicians as it may make their task easier and reduce insulin requirements. A close cooperation between the endocrinologist and the periodontist is vital to manage the patient's periodontal problems and diminish the detrimental effects of inflammatory disease on diabetes control and cardiovascular health. Working in concert, these two disciplines have a greater success in the diagnosis and control of diabetes and periodontitis.

Dr. Versman and Dr. Heller are Periodontists at Periodontal Associates in Aurora, CO and serve the entire Denver Metro and surrounding area. For more information, please visit www.periodontalhealth.com.

Periodontal Therapy for the Diabetic Patient

 Periodontal Associates - Therapy for the Diabetic Patient

Part of our role here at Periodontal Associates in Aurora, Colorado is to educate our patients and the Denver metro community. We have several useful health related articles involving the periodontal connection on our website. We have provided information about periodontitis and diabetes entitled "Periodontal Disease and Diabetes". It's a great article to share. 

Prevention, early diagnosis and consequent treatment of periodontal diseases may have a major impact on the control of diabetes. Research suggests that not only does diabetes influence the progress of periodontal diseases, but active periodontal disease also influeces the diabetic state.

The systemic inflammatory response generated by inflamed periodontal tissues aggravates insulin resistance and increases blood sugar, thus creating a vicious cycle of diabetes and periodontitis exacerbating each other and putting diabetic patients at increased risk for diabetic complications.

People with diabetes are more than twice as likely to have periodontal disease than people without diabetes because diabetics are more susceptible to contracting infections. This may be due to numerous physiological phenomena seen in diabetes, such as impaired immune resistance, vascular changes, altered microflora, and abnormal collagen metabolism. People with uncontrolled diabetes are especially at risk. A study in the Journal of Periodontology found that poorly controlled type 2 diabetic patients are more likely to develop periodontal disease then well-controlled diabetics.

Aggressive management of oral health in diabetic patients may diminish the adverse inflammatory effects on diabetes control. Several studies have reported that when periodontal infections were treated, the management of diabetes markedly improved. 

These studies suggest that the reduction of periodontal inflammation can be very helpful in controlling blood glycemic levels and reducing insulin requirements. 

For diabetics, periodontal disease therapy is a long-term venture, requiring some modifications of the customary periodontal treatment applied to non-diabetics. If you're concerned about your periodontal health, please contact Periodontal Associates to schedule a comprehensive exam. For your convenience, you may also email us at appointments@periodontalhealth.com or call (303)755-4500.