What is the connection between diabetes and periodontal disease?
Recent studies show that in type 2 diabetics, periodontal disease is more severe and more prevalent than in non diabetics. These studies further show that adult diabetes patients have greater tooth loss from periodontal disease than non diabetics of comparable age.

Diabetes Control.
Like other complications of diabetes, gum disease is linked to diabetic control. Researchers have found that patients with poor blood sugar control get gum disease more often and more severely, and they lose more teeth than do persons with good control. Children with IDDM (insulin-dependent diabetes mellitus) are also at risk for gum problems. Good diabetic control is the best protection against periodontal disease.
Studies show that controlling blood sugar levels lowers the risk of some complications of diabetes, such as eye and heart disease and nerve damage. Scientists believe many complications, including gum disease, can be prevented with good diabetic control.

Bacteria
Periodontal Disease is caused by bacteria, that multiply in the space between the teeth and the gums. Like other bacteria, the bacteria that cause gum disease thrive on sugars such as glucose, the sugar linked to diabetes. Studies done at Baylor University suggest that poorly-controlled diabetes also leads to higher levels of triglycerides and cytokinesoproteins which reduce the body's ability to fight periodontal disease.

Blood Vessel Changes
Thickening of blood vessels is a complication of diabetes that may increase risk for gum disease. Blood vessels deliver oxygen and nourishment to body tissues, including the mouth, and carry away the tissues' waste products. Diabetes causes blood vessels to thicken, which slows the flow of nutrients and the removal of harmful wastes. This can weaken the resistance of gum and bone tissue to infection.

Other Risk Factors
The effects of periodontal disease may be even more dangerous to diabetics than to non diabetics. Healthy eating is essential to controlling diabetes and missing teeth or dentures make many of the healthiest foods difficult to eat. Bone loss associated with gum disease may even make it difficult for dentures to fit properly. According to the AAP, periodontal disease appears to cause blood sugar levels to rise even more. And since diabetes and periodontal disease are both risk factors for heart disease, diabetics may have even more reason to want to prevent periodontal disease.
The American Academy of Periodontology offers excellent information about the connection between diabetes and gum disease at http://www.perio.org/consumer/mbc.diabetes.htm

Smoking
The harmful effects of smoking, particularly heart disease and cancer, are well known. Studies show that smoking also increases the chances of developing gum disease. In fact, smokers are five times more likely than nonsmokers to have gum disease. For smokers with diabetes, the risk is even greater. If you are a smoker with diabetes, age 45 or older, you are 20 times more likely than a person without these risk factors to get severe gum disease.

Dental Tips for Diabetics
Controlling your blood glucose is the most important step you can take to prevent tooth and gum problems. People with diabetes, especially those whose blood glucose levels are poorly controlled, are more likely to get gum infections than nondiabetics. A severe gum infection can also make it more difficult to control your diabetes. Once such an infection starts in a person with diabetes, it takes longer to heal. If the infection lasts for a long time, the diabetic person may lose teeth.
Much of what you eat requires good teeth for chewing, so it is extremely important to try to preserve your teeth. Because the bone surrounding the teeth may sometimes be damaged by infection, dentures may not always fit properly and may not be perfect substitutes for your natural teeth.
Taking good care of your gums and teeth is another important measure. Use a soft-bristle brush between the gums and the teeth in a vibrating motion. Place the rubber tip on the toothbrush between the teeth and move it in a circle.
If you notice that your gums bleed while you are eating or brushing your teeth, see a dentist to determine if you have a beginning infection. You should also notify your dentist if you notice other abnormal changes in your mouth, such as patches of whitish-colored skin.
Have a dental checkup every 6 months. Be sure to tell your dentist that you have diabetes and ask him or her to demonstrate procedures that will help you maintain healthy teeth and gums.

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