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Question:

From Santa Rosa, California, USA:

I am a senior citizen, and have had Type 2 diabetes for almost 5 years. I have always had good dental care with regular cleaning and exams, and have been told that my home dental care is excellent. Now I have been diagnosed as having periodontal disease with some bone loss. My question: Can diabetes be a contributing factor for periodontal disease and bone loss?

Answer:

Many conditions, such as retinopathy and neuropathy, are recognized as common complications of diabetes. One of the most prevalent complications of diabetes, periodontal disease, may be less widely recognised. Two basic clinical pictures can be present: gingivitis and periodontitis. Chronic gingivitis is an inflammatory response of the gingiva to dental plaque without necessarily any destruction of the supporting (connective) tissues. Periodontitis is an extension of the inflammatory process into all of the periodontal tissues, often leading to destruction of the connective tissue attachment and resulting in gingival recession, loosening and migration of teeth and possibly tooth loss. This trend may be modified by oral hygiene, duration of diabetes, age, and metabolic control of diabetes. Generally, poor oral hygiene, a long history of diabetes, greater age, and poor metabolic control are associated with more severe periodontal disease. The association of diabetes and periodontal disease may be due to various reasons such as impaired resistance of teeth, vascular changes, altered oral microflora (the bacteria normally present in the mouth), or abnormal collagen metabolism.

Recent studies have confirmed that, as for other diabetes complications although with some specific modifications, the same prevention and treatment procedures for periodontal diseases recommended for the general population are appropriate for those with diabetes. People with diabetes who appear to be particularly susceptible to periodontal diseases are those who do not are in good metabolic control, who do not maintain good oral hygiene, those with diabetes of long duration and with other complications, teenagers and pregnant women.

MS

Original posting 27 Apr 97

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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