Sweet tooth behind diabetes?

The oral cavity provides a continuous source of infectious bacteria and its condition often reflects progression of systemic illness. Historically , oral infections were thought to be localised to the oral cavity alone. A change in paradigm has dispelled this notion, and a whole new concept of the status of the oral cavity and its impact on systemic health and disease has evolved. Diabetes is a systemic disease with a number of major complications that may adversely affect quality and length of life, particularly as it relates to cardiovascular events and sudden death. Studies to date have reported conflicting associations between oral infection, and coronary heart disease.

However, there is evidence that dental infection is associated with coronary atherosclerosis and that bacterial DNA has been identified in atherosclerotic plaques, and other studies have related dental infection to the incidence of coronary events.

Periodontal disease has been reported as the sixth complication of diabetes, along with neuropathy , nephropathy , retinopathy, and microand macrovascular diseases.

Periodontitis is an inflammatory disease affecting the gums and the bone that supports the teeth. It is caused when germs in the plaque start infecting the gums.Many studies have been published describing the bidirectional interrelationship exhibited by diabetes and periodontal disease. Studies have provided evidence that control of periodontal infection has an impact on improvement of blood sugar control.

In addition to periodontal infection and gum inflammation, a number of other oral complications have often been reported in patients with diabetes. These include dryness of the mouth, dental caries, candida sis (a fungal infection), burning mouth syndrome, lichen planus, and poor wound healing. Proper management of these complications requires that they first must be properly diagnosed. Many of the problems can be properly identified by provision of a comprehensive oral examination at each medical or dental visit.

Dr Vinitha Ramachandran, Diabetes Hospital

PREVENTIVE MEASURES

Early diagnosis and proper treatment Periodic screening of adults and children with poorly controlled diabetes Oral health check-up as an integral component of overall diabetes management Sensitizing patients with diabetes on the risk factors Self-examining gums for signs and symptoms of inflammation Maintaining good oral hygiene.