Gum disease linked with diabetes

Gum disease and diabetes are chronic conditions that increase with age. The link between the two diseases goes both ways. It is thought that inflammation in the body is the connection- in fact, gum disease is the most common inflammatory disease. Gum (periodontal) disease includes gingivitis (inflamed gums) and periodontitis (inflammation of the gums and structures supporting the teeth). About 50% of people over 30 have periodontitis, which causes tooth loss if untreated, and it is this type of gum disease that is linked with diabetes.

The facts:

• Gum disease increases the risk of diabetes by 20-30%.
• Uncontrolled diabetes triples the likelihood of gum disease.
• People with diabetes have poorer blood glucose control, more heart, brain, eye and kidney complications, and a shorter lifespan, if they also have gum disease.
• Successful gum treatment reduces blood sugar levels.

Warning signs of gum disease:

• Red, swollen, bleeding, or receding gums.
• Bigger gaps between teeth, loose teeth.
• Bad breath, bad taste.

Prof Filippo Graziani, EFP president elect, said: "Bleeding gums are not normal - do not just rely on a mouth rinse but go see a dentist. The earlier we catch periodontitis, the better."

How to prevent gum disease:

• Clean between your teeth every day with an interdental brush or floss.
• Brush your teeth for at least two minutes, twice a day.
• Avoid smoking; eat a healthy diet high in fruits and vegetables and low in sugar, and exercise.
• Visit your dentist twice a year.
• Control your blood sugar if you have diabetes.

"Cleaning in between the teeth is the most effective way to prevent periodontitis," said Prof Graziani. "In addition, brush your teeth for a minimum of two minutes twice a day with an electric toothbrush. Most of us brush for just 35-40 seconds, which is not long enough. Every mouth is different and a dentist or hygienist can advise how to get the best results for you. And don't smoke - the majority of gum disease occurs in smokers."

Prof Antonio Ceriello, a diabetologist at MultiMedica, Milan, Italy, said: "Patients with types 1 and 2 diabetes who look after their teeth have better control of their diabetes and fewer long-term complications. This includes young people with type 1 diabetes. Check your gums and teeth regularly and see a dentist twice a year."

As a patient with type 1 diabetes,Dr Dániel Végh, who is a dentist at Semmelweis University, Budapest, Hungary, and regional representative for Europe, International Diabetes Federation Young Leaders Programme, said: "My routine is to brush and clean in between my teeth, then use mouth rinse, at least two times a day. I can't see every area of my teeth in the mirror, so I visit my dentist every six months for a clean and check-up. I go for extra visits if there is bleeding anywhere in my mouth."

For more information on the links between gum disease and diabetes please visit the dedicated Perio & Diabetes website, which has leaflets for patients and the public, the media, medical professionals, and policymakers.