Our wonderful bodies are made up of a complex network of organs and organ systems that serve specific functions and enable us to enjoy the beautiful world around us. Although we may not be conscious of how each organ is connected to the other, we are frequently reminded of this fact. November was diabetes awareness month and while we direct our attention to better food and drink choices, adopting a healthier lifestyle, and controlling blood sugar levels with medications, as a Dentist I would like to bring to light some of the effects diabetes has on our teeth and gums.

Diabetes mellitus and periodontal disease (also known as the disease of the tooth-supporting structures) are chronic diseases affecting a large number of populations worldwide.

Diabetes affects various parts of our body and can cause retinopathy, neuropathy, and nephropathy. In addition to these, diabetes also has an effect on the synthesis and breakdown of bone in our body also known as bone metabolism.

Alveolar bone (the bone that supports our teeth) loss is one of the main outcomes of periodontal disease, and diabetes is among the primary risk factors for periodontal disease. Studies have shown the risk of periodontal disease to be 3-4 times higher in people with diabetes than in non-diabetic individuals and patients with diabetes mellitus are at risk of having more severe forms of periodontal disease. The severity of periodontal disease is related to the level of glycemic control. This means if a diabetic patient has poorly controlled blood glucose levels, their periodontal condition is likely to get worse which can cause teeth to become loose, abscesses to form in their gums for no apparent reason, and may also result in slow healing after dental procedures such as a tooth extraction or deep cleaning. Other oral manifestations of uncontrolled diabetes can include xerostomia (dry mouth), burning sensation in the mouth (which may possibly be related to neuropathy), impaired/delayed wound healing, increased incidence, and severity of infections, secondary infection with candidiasis and parotid salivary gland enlargement.

Diabetes and the complications associated with it can be debilitating for many individuals. Treating this complex disease takes a team of healthcare providers from various disciplines who are able to assess the patient and provide recommendations for treatment. From a dental standpoint, it is crucial that diabetic patients visit their dentist every 6 months and follow the recommendations of their dentist for treatment. Maintaining a good oral hygiene regimen at home is also essential to alleviate the effects of diabetes on periodontal tissues. Just as your eyes are considered as windows to your soul, your oral health is the window to your overall health.