Periodontal disease affects millions
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By George Malkemus  October 29, 2009 04:46 pm

Gum disease, or periodontal disease is a bacterial infection of the gums that affects more than just the mouth. It plays a role in numerous disease conditions throughout the body including heart disease, strokes, ulcers and adverse pregnancy outcomes such as low birth weight and preterm births.
Diabetes is also affected and increased by periodontal disease, which alters blood sugar control in diabetics. Bacteria that build up between the tooth and gum can enter into the bloodstream when gums bleed. These bacteria can travel throughout the body and cause serious health problems.
Periodontal disease can be prevented with good oral health habits like brushing and flossing, and regular professional cleanings.
Both diabetes and periodontal disease are chronic inflammatory diseases that have a major impact on the health of millions of people worldwide. Gum disease is rampant in our society, more than half of all people over 18 have at least the early stage of periodontal disease. After age 35, three out of four adults are infected.

Diabetes on the rise
Meanwhile, diabetes and obesity rates in North America have been increasing substantially over the last 20 years. There are over 23 million diabetics in the United States alone and over 170 million worldwide.
The word diabetes derives from the ancient Greek meaning “to pass through urine.” With this disease, abnormally high blood sugar glucose levels lead to high levels of glucose passing through to the urine. Glucose is the body’s primary energy source and is controlled by the hormone insulin produced in the pancreas.
In Type 1 diabetes the production of insulin is diminished leading to high blood glucose levels. High blood glucose levels form in Type 2 diabetes and gestational or pregnancy diabetes due to insulin being ineffective.
Signs of diabetes include excessive urine production, extreme thirst, blurred vision, unexplained weight loss, tiredness and stupor - like a drunken state.

Both are killers
Both diabetes and gum disease are silent killers, usually both diseases are painless until advanced and lead to major problems. Often when diabetes is out of control with hyperglycemia, there are no symptoms. But high blood glucose levels can lead to serious problems over time, including kidney disease, blindness, foot problems, heart disease and nerve damage.
Kidney disease can lead to kidney failure and the need for dialysis. Blood vessel damage in the eyes can lead to blindness. Heart disease can lead to death. In fact, heart disease is the number one cause of death in people with diabetes.
Nerve damage in the feet can lead to the need for amputation. Neuropathy, particularly numbness of the feet is a common problem with diabetics.
My father, Gene, has had diabetes and taken insulin shots daily since 1993. He has numbness in his feet. Many years ago, he was changing into his golf shoes before a round of golf and could not find his shoehorn that he always used to put on his golf shoes. Finally he gave up looking and forced his shoes on without the shoehorn.
After walking to the sixth hole at Indian valley golf Course in Novato, something did not feel right, so he took off his shoe and found the shoehorn in the golf shoe. He never felt a thing. He has always worn white shoes since then to determine if there have been any bleeding sores on his feet.

It’s often painless
Periodontal disease is often painless, and usually develops slowly over many years, but may progress in rapid destructive stages. The bacterial infection attacks the gums and bone that support the teeth and hold the teeth in the jaw. The major cause of tooth loss is due to gum disease.
Diabetics are three to four times more likely to have periodontal disease due to their reduced immune and healing response. It is extremely important for diabetics to have excellent oral hygiene and regular professional cleanings.
The presence of any gum infection can make it much more difficult for a diabetic to control his or her blood sugar. Diabetics without periodontal disease have shown six times better blood sugar control versus diabetics with gum disease.

Proof’s in the (sugar-free) pudding
Studies have also shown that the elimination of gum disease can directly improve a person’s control over diabetes dramatically.
Eliminating periodontal disease has definitely contributed to my father’s control of his diabetes. When I started practice on April 1, 1985, my father was my first patient. He had periodontal disease at that time including a loose molar. With professional periodontal treatment, the gum tissue around that molar tightened up and he still has it today. He is meticulous with his oral hygiene and receives cleanings every three months.
A 1997 study of 113 Pima Indians in Arizona showed that reducing their periodontal infection significantly improved their control of diabetic sugar levels. Pima Indians were known for their high number of diabetics and an increased proportion of periodontal disease. After intense treatment to reduce their gum disease, the study found vast improvement in their diabetes with a reduction in the amount of insulin needed. In some cases, patients experienced complete removal from need for medications.
Diabetics with gum disease have a greater risk for cardiovascular and kidney complications than diabetic patients without periodontal disease. In a study of over 600 diabetic patients, the death rate was over 2.3 times higher from heart attacks, and 8.5 times higher from kidney disease in individuals with severe periodontal disease.
My father has not had any gum disease since I started the practice in 1985 and he has not had any heart or kidney problems that are common with diabetics

George Malkemus has had a Family and Cosmetic Dental Practice in Rohnert Park for over 23 years in Rohnert Park. He can be contacted at 585-8595 or

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