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Diabetes is a risk factor for gum disease

The British Society of Periodontology (http://www.bsperio.org.uk), together with Diabetes.co.uk (http://www.diabetes.co.uk), is running a campaign to raise awareness of the increased risk of gum disease in people living with diabetes.

Periodontal (gum) disease is the 6th most common disease in the world.  You are all aware of the impact it can have on quality of life, include bleeding gums, receding gums, loosening teeth, discomfort when chewing and eventually tooth loss.  However, the good news is that it can be prevented and easily treated in the early stages of the disease.

How are Gum Disease and Diabetes linked?

Diabetes.co.uk and the British Society of Periodontology recently carried out a survey of people living with diabetes.  It showed three quarters of them had experienced bleeding gums when brushing.  Worryingly only around 50% had ever received information about gum disease from either a dentist, or a doctor or a pharmacist.

Poorly managed blood sugar levels in people with diabetes cause damage to nerves, blood vessels, the heart, the kidneys, the eyes and the feet.  In the same way, the gums can also be affected.  The damage to the blood vessels, make infections of the gums, and the bone supporting the teeth, more likely.  Poorly controlled blood sugar levels lead in turn to a rise in sugar levels in saliva, which feeds the bacteria and increases the formation of dental plaque.

Evidence shows that severe periodontal disease can increase blood sugar levels in people with diabetes and also in those who do not have diabetes.   Interestingly, there is some scientific evidence to suggest that having treatment for gum disease can improve long-term blood glucose levels in people with poor control.   This in turn lowers the risk of experiencing the other common long-term complications of diabetes, including heart and kidney disease.

In other words, we now know that periodontal disease and diabetes are linked in both directions.  Keeping blood glucose levels low and stable can reduce the risk of gum disease; and looking after oral health could help to improve long-term outcomes in people living with diabetes.

How can you as dental nurses help with the campaign?

Dental nurses can help to raise awareness by taking the following steps:

Ask: Ask all patients when they come for a check up and routine care about their medical history.  If you find out that they are living with diabetes ask them if they know that gum disease is a complication of their diabetes and that gum disease can affect their diabetes care.

Advise: Inform the patient that the dentist will carry out a periodontal health screening and arrange treatment if necessary.

Act: Let the dentist know that the patient has diabetes.  Let other members of the practice know about the Gum Health Awareness Campaign.

The following poster for healthcare professionals explains the key messages:

http://www.bsperio.org.uk/howsyoursmile/diabetes2017/Health-Care_Professionals.pdf

The following patient poster can be displayed in waiting rooms:

http://www.bsperio.org.uk/howsyoursmile/diabetes2017/Patient_gum_awareness.pdf

Dental nurses can help people living with diabetes by giving them the information they need to take responsibility for their oral health?   As well as reducing the risk of contracting periodontal disease there are a host of reasons why good dental health habits are important including: to reduce the risk of tooth decay; to have fresh breath and to increase self esteem.  It has been shown that people have less respect for those with poor oral hygiene, which can impact on workplace opportunities.

Patients may find it useful to visit the British Society of Periodontology website for further information including the recently updated patient information leaflet.

http://www.bsperio.org.uk/publications/downloads/95_105645_bsperio-patient-information.pdf