Greater risk of loosening of the teeth among diabetics

Henrik Jansson’s dissertation Studies on periodontitis and analyses of individuals at risk for periodontal diseases covered nearly 200 patients with type 2 diabetes, so-called adult onset diabetes. As many as every fifth patient suffered from severe loosening of the teeth, periodontitis. What’s more, it turned out that the occurrence of cardiovascular diseases was significantly higher among diabetics suffering from severe periodontitis.

“This discovery is interesting because there has been a great deal of talk about the connection between cardiovascular disorders and periodontitis. But the underlying causes have not been clear. One hypothesis is that chronic inflammatory processes, in the gums, for instance, can influence mechanisms in other parts of the body as well,” says Henrik Jansson, a specialist in periodontology and instructor at the Faculty of Odontology in Malmö.

Periodontitis is a chronic inflammation that arises in response to the natural flow of bacteria in the mouth. There is a genetic factor involved; the disease “can be passed on from one generation to another,” says Henrik Jansson.

“When the bacteria are not removed from the edge of the gums, an inflammation occurs. But in especially sensitive individuals it doesn’t stop there. The inflammation leads to the loss of supportive tissue and the teeth lose their anchoring.”

One major problem involving periodontitis is that the disease is not always noticeable. It rarely causes pain, and the symptoms can be so faint that the victims are not aware of what is going on their oral cavity. Bleeding gums, teeth that are loose or shifting–these are often the first noticeable signs.

“If the disease is discovered in time, it is often sufficient to carry out a professional cleaning. On the other hand, if it has progressed further, surgery may be needed,” says Henrik Jansson.

Another major problem is the tremendous private cost of dealing with periodontitus.

With the aim of preventing the disease, Henrik Jansson would like to see better information targeting relevant risk groups and regular check-ups by a dentist or dental hygienist. Just as in all chronic diseases it’s important to get patients to understand their sickness. Improving patients’ oral hygiene and professionally executed cleaning are other important steps in treating the disorder.

“To minimize the risk of relapse it is also important to work on patient motivation, both during and following treatment,” Henrik Jansson points out.

In his study, Henrik Jansson also investigated the effect of treatment with an antibiotic gel in patients with severe periodontitus. The gel has been touted by its producer as a more convenient alternative to the conventional mechanical treatment. However, the study was unable to confirm any such effect. This corroborates what the Swedish Council on Technology Assessment in Health Care (SBU) arrived at in a report from 2004.