Diabetes & Periodontal Disease

Two Diseases with a Common Enemy... You!

(Continued)

Periodontal Disease — More Than A Mouth-Full

While periodontal diseases may be isolated to the mouth, their effects are not: research is beginning to uncover a relationship between periodontal health and general health. Known risk factors for periodontal disease include smoking and diabetes.

Periodontal disease (peri-around, odont-tooth), or gum disease as it is commonly called, is really a group of diseases caused by dental (bacterial) plaque — the biofilm that collects between the teeth and gums in the absence of effective daily oral hygiene. The end results are the same — destruction of the periodontal tissues which include gingivitis (inflammation of the gums) and periodontitis (the loss of bone and the surrounding periodontal structures).

Nearly all people will develop gingivitis in the absence of good oral hygiene; however, only about 10-15% of people go on to develop more advanced periodontal disease with the loss of supporting bone and eventual tooth loss.

The immune system is the body's way of protecting itself against disease. It is made up of a complex recognition and response system to bacteria or other pathogenic (disease-causing) organisms. Generally, once recognized, specific antibodies to organisms will allow a more rapid response in the future. The immune system responds in different ways to different bacteria in dental plaque. This highly complex interaction gives rise to varying patterns of disease, depending upon which bacteria are involved and which components of the immune system are activated.

Diabetes also results in changes in the function of the immune cells responsible for normal inflammatory response and wound healing. Since the immune system may be compromised in diabetes it can also affect the severity of periodontal disease.

But Why?

One of the major body responses mediated by the immune system is inflammation. Inflammation is actually the immune system at work, trying to isolate disease and prevent spread to other parts of the body and repair the effects of disease. Defense cells and their products get rid of pathogenic (disease causing) bacteria and damaged tissues by the repair process that occurs during wound healing. Unfortunately, the body's immune system can be impeded by a number of factors, heredity being one of the most critical. Certain groups of people carry genes that may predispose them to periodontal and other inflammatory disease like diabetes.

Family history of periodontal disease and diabetes may be an important clue to this since we inherit our genes from previous generations. Genetic testing has recently been developed that helps identify such people, but the genetic components of wound healing are complex and not easily identified by simple genetic tests. Another impediment to the immune system is stress, brought on by physical illness or severe emotional distress. Stress can affect the immune system by lowering resistance, which impedes its ability to fight disease.

Chronic or prolonged inflammation, leads to a progressive shift in the type of cells that are present at the site of inflammation and is characterized by simultaneous destruction of tissues alongside attempts at healing. Inflammatory products may play a major role in the mechanisms and complications of diabetes.