Diabetes and Periodontitis, a Two-way Street

Oral health, diabetes and periodontitis

diabetes, gum disease, doctor, oral health, periodontitis

GUM DISEASE CONCEPT Medicine doctor hand working

Diabetes is a major concern for tens of millions of Americans. While most of us are familiar with the insulin and metabolic complications associated with diabetes there are far fewer that are aware of the increased prevalence of gum disease, tooth decay and other oral health problems amongst diabetics.

What is even more surprising is the increased evidence from medical studies showing that there is a “two-way street” relationship between diabetes and oral health. In other words, evidence suggests that:

  • Diabetics are more likely to suffer from serious gum disease, periodontitis and
  • Periodontitis decreases the body’s ability to control blood glucose, thus gum disease is a factor in aiding the progression and development of diabetes

This was covered in a clinical study that researched the link between treating periodontal disease with SRP (scaling and root planing, or a deep cleaning) and the effect upon glycemic control in diabetic patients. Clinical study on periodontal disease and diabetes, glucose management

The following is taken from that study:

“Periodontal disease and diabetes mellitus (DM) share a two-way relationship. It can be hypothesized that successful management of periodontal infection in diabetes will lead not only to reduction of local signs and symptoms of the disease, but also to better control of glucose metabolism… The result indicates that SRP is effective in improving metabolic control in Type 2 Diabetes Mellitus patients”

Another respected site, www.diabetes.org, also supports these findings with their statement that:

“Emerging research also suggests that the relationship between serious gum disease and diabetes is two-way. Not only are diabetics more susceptible to serious gum disease, but serious gum disease may have the potential to affect blood glucose control and contribute to the progression of diabetes. Research suggests that diabetics are at higher risk for oral health problems, such as gingivitis (an early stage of gum disease) and periodontitis (serious gum disease). Diabetics are at an increased risk for serious gum disease because they are generally more susceptible to bacterial infection, and have a decreased ability to fight bacteria that invade the gums.”

“If your blood glucose levels are poorly controlled, you are more likely to develop serious gum disease and lose more teeth than non-diabetics. Like all infections, serious gum disease may be a factor in causing blood sugar to rise and may make diabetes harder to control.”

The relationship between diabetes and periodontal disease is well established and it is a recognized fact that diabetic patients are more likely to experience gum disease and tooth loss. It is an increasingly recognized fact that those with gum disease have an increased risk of developing glucose intolerance issues that contribute to the progression of diabetes.

What is also recognized is that these increased risks and prevalence factors are far more likely to be found in uncontrolled cases. Simply put in those that do not take adequate care of their mouth and gums or their glucose management.

As this earlier study showed, effective periodontal treatments, in this study a SRP–Scaling and Root Planing–was used, demonstrated the added benefit for diabetic patients of an improved blood glucose and diabetic condition.

However, as other clinical studies show, the SRP treatment is limited in that the “bad bacteria” rapidly grows back and the condition returns. These treatments can be greatly enhanced in efficiency by the addition of using oral probiotics to support a healthy bacterial culture in your mouth and gums. (See our earlier blog post on this subject: Lactobacillus reuteri and chronic periodontitis).

As those that suffer from it know, diabetes is a serious disease with multiple complications that severely impact one’s quality of life. Taking effective measures to control diabetes can provide strong positive benefits and extend one’s life. One such effective measure is to address the state of your oral health. Deep cleanings, periodontal treatments, ongoing hygiene and the regular use of oral probiotics are all effective in promoting superior oral health and combating periodontal disease.

The advanced oral probiotic blend from Great Oral Health provides a broad spectrum of beneficial bacteria along with key ingredients designed to help remineralize your teeth. If you, or someone you care for, is diabetic then improving the level of oral health is a key step in effective management of that disease.

Oral Probiotic Lactobacillus reuteri and chronic periodontitis

A Clinical Study Shows Significant Periodontal Results from Oral Probiotic Lactobacillus Reuteri

periodontal disease, image of healthy gums, unhealthy gums, oral probioticsThere are multiple clinical studies on the use of oral probiotics in the treatment of periodontal disease. This 2013 study focused on the use of the oral probiotic Lactobacillus reuteri together with the standard and commonplace treatment of “Scaling and Root Planing” or as you probably know it, a deep cleaning. SRP is how your dentist or periodontist would first tackle heavy plaque build-up, deep gum pocket depths and gingivitis.

The question that the clinical researchers had was “Would the oral probiotic Lactobacillus reuteri be effective as an adjunct to a SRP treatment?”

This clinical test was the first to measure the benefit of combining a deep cleaning (SRP) with oral probiotics. A primary purpose of doing a deep cleaning (SRP) is to disrupt the growth of the pathological bacteria that is largely responsible for periodontal disease. The problem is that although SRP does a great job of disrupting the bacterial growth the stuff grows right back! So, the researchers were studying to see if a longer term and beneficial effect could be obtained by using oral probiotics as an adjunct to SRP.

The clinical study results were published in the Journal of Clinical Periodontology in 2013 and conducted by several universities, two in Belgium and one in Turkey.

They tested two groups of chronic periodontitis patients, both groups received the SRP treatment, then one group took oral probiotics and the other took a placebo.

The patients were measured and monitored for such things as: probing pocket depth (how deep your gum pockets are), the gingival recession (the gingiva are basically your gums), the bleeding on probing and also measured for bacteria that were present in the mouths of each patient.

The patients were measured throughout the 12-week clinical test.

Results of Using Oral Probiotic Lactobacillus reuteri along with a Deep Cleaning

While both groups saw improvement over the baseline (starting point measurements) the results showed significant improvement in the group that took oral probiotics over the group that took a placebo.

The group that took oral probiotics saw a significant reduction in pocket depth (meaning that the gums were attaching) and less bleeding on probing.

Using Oral Probiotics to Reduce the Future Risk of Periodontitis Disease Progression

Most interesting was the assessment done on all patients at the end of the trial to determine their future risk of “disease progression” and in the high risk group the numbers were 67% for the non-oral probiotics patients versus only 27% in the group that took oral probiotics. In the low risk group it was even more impressive as 60% of the oral probiotic users fell into the low risk group for future disease progression versus only a mere 13% for the non-users!

Moral of the story is that combining SRP with the use of oral probiotics is significantly better than just SRP alone, particularly if you want to avoid future treatments and improve your gum health.

And these results were measured after only 12 weeks and by using just with one oral probiotic, L. reuteri, so we will await any clinical studies that look at longer time periods and/or a blend of oral probiotic strains.

One of the reasons we built our Great Oral Health formulation with a total of seven strains of beneficial oral probiotics is that they each bring a benefit to your mouth and work synergistically for a healthier oral environment. We think that taking a daily oral probiotic supplement is preferable by far to ongoing deep cleanings, and more economical to boot!

The study can be found by search for: J Clin Periodontol 2013; 40: 1025–1035. doi: 10.1111/jcpe.12155.

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