Smoking and diabetes: risk factors for gum disease

  • Published
  • By Capt. Ben Lee
  • 95th Medical Operations Squadron
Periodontal disease is an infection of the gum and underlying bone tissues that support your teeth.

As you look in the mirror, your gum tissue may not appear to be attached to the teeth as high as it once used to, and your gums may feel sore, soft, and cratered and may bleed when you brush them.

These symptoms are typically caused by poor brushing and flossing habits that allow plaque -- a sticky film of bacteria -- to build up on the teeth and harden.

Plaque and tartar can build up below the gum line in the sulcus and damage the tissues by causing an infection. As the tissues are damaged, the sulcus develops into a pocket. Generally, the more severe the disease is, the greater the depth of the pocket.

In advanced stages, periodontal disease can lead to bleeding gums, painful chewing problems and even tooth loss.

There are a number of risk factors for gum disease, but smoking is the most significant. Most studies have found that smokers have greater amount of plaque and calculus accumulation, greater pocket depths and bone loss.

Also periodontal healing is slow in these patients because of their impaired blood functions, which results in an impaired immune system. Therefore, smoking can definitely jeopardize the success of treatment.

Depending on the extent of the gum disease, treatments can range from a professional deep cleaning to medications and surgery.

While periodontal disease can be treated, more importantly, it can be prevented. Daily brushing and flossing, regular dental check ups and quitting tobacco use are the best defense against periodontal disease.

Another risk factor for periodontal disease is diabetes mellitus.

It is well established that patients with diabetes mellitus are more prone to periodontal destruction. For well-controlled diabetics, periodontal disease responds well to therapy and can be managed successfully.

Many changes occur in your body when you have diabetes.

In the gums, microvascular changes occur similar to those in other organs. These changes result in impaired oxygen and nutrient delivery to the gingival tissues.

Also, impaired white blood cell function occurs and may be responsible for severe periodontal destruction in diabetics because they are not able to get rid of the invasive, pathogenic bacteria.

Furthermore, a diabetic's equilibrium may become altered resulting in increased collagen breakdown and rapid periodontal destruction. Collagen is a protein found in all connective tissues of the body, including the gums and bone. Normal collagen turnover occurs with new collagen production replacing the old. This is necessary for maintaining periodontal health.

In conclusion, you might have periodontal disease and not know it. That is why regular dental checkups and periodontal exams are important. Treatment outcomes depend on how far your disease has progressed. Good oral hygiene at home is very important, so brush, floss, eat good foods and visit your dentist regularly.