Periodontitis is a far-reaching disease; it does not only harm our teeth, it affects our entire body. This can become particularly critical for people with diabetes. Read more about it in this blog article by Dr. Roberto Lhotka!
You probably know that sugar is bad for your teeth and oral health, but do you also know why?
Sugar contains glucose. An excess of glucose in saliva can promote the growth of plaque and thus harmful bacteria in the mouth. This in turn can lead to gum inflammation, which can develop into periodontitis - a severe infection that damages the soft tissue in the mouth and destroys the bone that supports the teeth.
For people with diabetes, the risk is even greater, as this chronic condition impairs the body's ability to process glucose. As a result, high blood sugar levels can damage blood vessels and nerves, making it even more difficult to contain the progression of the disease. This increases the likelihood that a simple gum inflammation will develop into advanced gum disease.
What is periodontitis?
Periodontitis, also often referred to as "periodontal gum disease," is a chronic inflammatory disease of the gums caused by bacteria. When bacteria remain on or between the teeth for too long, dental plaque forms, which eventually hardens into tartar if the plaque is not properly cleaned. Periodontitis is colloquially also often called periodontal disease, but the correct medical term is periodontitis.
There are various stages of periodontitis, ranging from mild to severe. In advanced periodontitis, the gums recede, and the bone that holds the teeth is broken down. The periodontal apparatus is destroyed, meaning the fibers that connect the tooth to the bone are destroyed.
Gingivitis is the preliminary stage of periodontitis, in which the gums are swollen and mildly inflamed, and bleeding gums may occur. If the cause of the inflammation is not treated, it can develop into periodontitis.
While gingivitis is limited to inflammation along the gum line and is generally reversible - meaning it can be reversed - periodontitis can cause irreversible damage such as loss of jawbone, root cementum, and periodontal ligament.
How does periodontitis develop? The three stages of periodontitis
Periodontitis can be divided into three stages: early, moderate, and advanced.
Periodontitis - the early stage
In early periodontitis, the gums begin to pull away from the teeth, leading to periodontal pockets where food, plaque, and bacteria accumulate. This causes infections.
Periodontitis - the moderate stage
In moderate periodontitis, symptoms increase as more bone substance is lost, the gums recede, and the teeth become loose.
Periodontitis - the advanced stage
In advanced periodontitis, the infection has spread beneath the gums, leading to painful abscesses and possible tooth loss.
The severity at which the disease progresses depends on several factors, including:
- The type and number of bacteria present
- How healthy the affected person's immune system is
- Presence of risk factors such as diabetes or smoking
- Genetic factors
- Certain medications that affect the inflammatory response (e.g., blood pressure-lowering or vasodilating medications)
- How quickly treatment is sought
Symptoms of gum inflammation and periodontitis
To avoid permanent damage to the teeth, gums, and surrounding bone, periodontitis should ideally be detected early, preferably while it is still an early-stage gum inflammation.
Early warning signs of gum inflammation include:
- Recurring bleeding gums when brushing, flossing, or eating
- The gums in the affected areas appear red and swollen
- Sensitive gums
- Bad breath
- Pain at the inflamed area or when chewing
- Plaque deposits at the base of the teeth
Some of the symptoms of advanced periodontal disease are:
- Loose or wobbly teeth
- Receding gums or teeth that appear "longer"
- Pus between teeth and gums
- Increased spacing between teeth
- Changes in how the teeth fit together when you close your jaw
- Possible tooth loss in the advanced stage
Risk factors for periodontitis
Several factors can increase your risk of developing periodontitis, including:
- Smoking
- Genetics
- Age
- Type 2 diabetes
- Stress
- Poor diet
Smoking
Smoking accelerates the progression of periodontitis. Furthermore, the success rate of periodontal treatments is lower in smokers because healing is impaired.
Genetic factors
The genes responsible for building the immune system also influence your predisposition to gum disease.
Age
Periodontitis progresses slowly, so the first signs of gingivitis may appear as early as age 30 but may not develop into periodontal disease until age 50. With the natural aging process, the gums and teeth also change, which means the consequences of gum disease and the potential for tooth loss are greater with age.
Diabetes
Type 2 diabetes is another significant risk factor for periodontitis. When blood sugar is not well controlled, there is a higher potential for developing periodontitis. Interestingly, there is a bidirectional effect between periodontitis and diabetes. Uncontrolled blood sugar can lead to periodontitis, and periodontitis can increase the risk of diabetes. We will explore the connection between periodontitis and diabetes in more detail in the next section.
Unhealthy diet
Diet is also a factor in periodontitis. A diet high in refined carbohydrates and industrially processed foods can increase the risk of gum inflammation. An unhealthy, sugar-rich diet can also increase the risk of developing type 2 diabetes, which raises the likelihood of periodontal gum disease. Also read my blog article about sugar on this topic: Here
Stress
Stress can weaken the immune system, making it more difficult to fight off gum infections, which means the infection can develop faster than the immune system can handle it. Additionally, people who are stressed or suffering from mental health conditions are less likely to maintain their oral hygiene.
The connection between periodontitis and diabetes
There is a close connection between periodontal gum disease, particularly periodontitis, and diabetes. People with diabetes are more likely to develop periodontitis. Furthermore, it has been proven that periodontitis can make it more difficult to control blood sugar levels. This is partly because the inflammation caused by periodontitis can impair the body's ability to use insulin, the hormone responsible for regulating blood sugar levels.
In addition, diabetes alters the quality and composition of saliva, which plays an important role in oral health. Saliva lubricates the mouth and washes away food particles, protects tissue, and prevents the growth of bacteria. People with diabetes often produce less saliva, leading to a dry mouth, and their saliva may have a higher glucose content. This promotes the formation of plaque and the growth of bacteria, which in turn leads to an increased risk of periodontitis.
Furthermore, high blood sugar levels can slow down the healing process of a gum inflammation, giving it more time to spread and cause damage beneath the surface.
If your dentist diagnoses you with periodontitis, you should also ask your general practitioner to measure your blood sugar levels. Conversely, it is important to inform your dentist that you have diabetes so that the health of your gums can be monitored particularly closely. The type and approach of treatment also depend on this.
Treatment of periodontitis in diabetes
The treatment of periodontitis and diabetes is most effective when detected early. If it has been determined that you may be pre-diabetic, simple lifestyle changes may be sufficient to bring blood sugar back under control. However, if you have received an official diabetes diagnosis, you may need medication to control your blood sugar levels.
The same applies to periodontitis. Gingivitis or early-stage gum inflammation is easier to treat than periodontitis, which may require more invasive procedures and causes long-lasting damage. Have your treating dentist advise you in detail and be sure to mention your diabetes condition, as this is a decisive factor in creating the treatment plan.
Studies show that treating periodontitis can lower blood sugar levels in people with diabetes. Therefore, it is important to treat the condition promptly to avoid further diabetes-related complications.
Can periodontitis be cured?
For patients who suffer from both periodontitis and diabetes, good blood sugar control can significantly contribute to the healing and prevention of periodontitis.
Of course, good oral hygiene and regular visits to the dentist are the best way to prevent gum inflammation from progressing to periodontitis.
The goal of periodontitis treatment is to reduce swelling and inflammation in order to stabilize the bone and gums.
How can periodontitis be treated?
Depending on how advanced the periodontitis is, various non-surgical or surgical treatments may be used.
Non-surgical treatment may include antibiotics, scaling, or root planing. Personally, I try to avoid the use of antibiotics, as they disrupt the oral biome and often provide short-term improvement while simultaneously causing long-term deterioration of the condition. As an alternative, I developed the Dr. Lhotka Vienna Organics Organic Dental Oil Concentrate, which I have been successfully using in my practice for many years.
In any case, one of the first steps is tartar removal. During scaling, tartar and bacteria are removed from the tooth surfaces and below the gum line using a laser or ultrasonic device. During root planing, the surface of the tooth roots is smoothed to prevent further accumulation of bacteria and tartar.
In advanced periodontitis, surgical intervention may be necessary. Depending on the condition, this may include surgical pocket reduction, soft tissue or bone grafting, guided tissue regeneration, or the application of a tissue-stimulating protein gel to the affected area to promote the growth of bone and tissue. In many cases, the minimally invasive pinhole technique can help, which I have been practicing as the only physician in Austria for many years.
Holistic lifestyle tips for reducing the risk of periodontitis
Gum inflammation and disease can easily be prevented by adopting healthy lifestyle habits and attending regular check-ups and preventive examinations. Below are some tips for treating and preventing gum inflammation.
A good oral hygiene routine as the foundation of dental health
Good oral hygiene is important to reduce the risk of periodontitis.
- Brush your teeth twice a day
- Use dental floss every day
- Choose a soft toothbrush and replace it every three months or as soon as the bristles start to bend
- Use a mouthwash or mouth rinse after brushing your teeth
- Visit your dental hygienist regularly for professional teeth cleaning
- If you feel that your gums are inflamed, see your dentist immediately
- If you smoke: stop immediately
Also read my blog article on the correct tooth brushing technique!
Use my organic dental care products
I have been a dentist for several decades and therefore know the challenge of finding the "right" dental care. That is exactly why I developed an organic dental care line - because I wanted a toothpaste that prevents, nourishes, and heals.
With my products, I place the greatest emphasis on high-quality, effective, and natural products that help you optimize your oral health. The dental care products contain plant-based active ingredients such as cinnamon, cloves, lemongrass, and thyme, which provide effective protection against inflammation and harmful bacteria.
Dr. Lhotka Vienna Organics Organic Toothpaste:
The highly effective herbs and essential oils heal and protect the gums, harmonize the oral flora, and provide lasting relief from bad breath.
Dr. Lhotka Vienna Organics Organic Mouthwash:
The naturally antibacterial properties of the herbs and essential oils in this formula promote faster healing of inflammation in the mouth, help with bleeding gums, and freshen breath. Mix a few drops into a cup of water, rinse for 30 seconds, and spit it out.
Dr. Lhotka Vienna Organics Organic Dental Oil:
This dental oil concentrate can be applied to dental floss and used after brushing - due to its concentration, just a few drops are sufficient!
Monitor your blood sugar levels
- If you have diabetes, measure your blood sugar levels regularly
- Drink plenty of water (2-3 liters per day)
- Eat a healthy diet rich in vegetables, protein, and fiber and low in sugar
- Avoid processed foods and refined carbohydrates
- Add a spoonful of apple cider vinegar to a glass of water and drink it before meals
- Regular exercise - walks after meals are particularly well suited for balancing blood sugar levels