Diabetes Developments

Mouth Control

Our mouths are key to diabetes control. And not just what we put in them.

How would you like to reduce your A1C level by 0.67 percent — like from 6.67 to 6.0 — without putting less in your mouth or even increasing your exercise? This third type of A1C control may be the easiest ever.

Research presented at last month’s Scientific Sessions of the American Diabetes Association that I attended in San Francisco made this point. Dr. George Taylor, associate professor of dentistry at the University of Michigan, reported there on recent studies demonstrating the association between periodontal problems and the complications of diabetes. He spoke in the first symposium ever by dentists to ADA meetings.

As long ago as 1993 we have known from the research of Professor Harald Löe that periodontal disease is “the sixth complication of diabetes.” And now a new analysis of the First National Health and Nutrition Examination Survey (NHANES I) and its Epidemiologic Follow-up Study (NHEFS) shows that periodontal disease is a good predictor of whether someone will get diabetes. An abstract of that study, “Periodontal Disease and Incident Type 2 Diabetes,” is online, and Dr. Bill Quick, who also writes here at HealthCentral.com, sent me the full-text.

I think of periodontal disease as an arrow pointing at us in both directions. It can be both a cause and an effect of diabetes.

The new research looks at the effect of periodontal disease on diabetes. “Improvements in periodontal disease benefit diabetes control,” Dr. Taylor says. He and his associates conducted a randomized clinical trial of 46 people with type 2 diabetes. And then 15 months after their routine periodontal treatment, the researchers found a statistically significant reduction of 0.67 percent in their A1C levels.

Periodontal disease goes by at least three names. Technically, it’s periodontitis. To those of us with diabetes it’s generally gum disease.

By whatever name, it is an infection and chronic inflammation of the tissues surrounding and supporting our teeth. When we let plaque harden into tartar, our gums gradually begin to pull away from our teeth. That forms pockets between our teeth and our gums, and if we let it go on long enough, it’s one of the main reasons why adults lose their teeth.

Periodontal disease has another thing in common with diabetes. Both diseases are insidious. We generally don’t feel pain from either — until it’s too late.

Personally, the only pain I ever felt from my periodontal disease came about 20 years ago when a dentist had to operate on my gums. It’s such a painful process that he had to do it in four separate operations.

Since then I’ve kept my gums under pretty good control with regular brushing with a Sonicare electronic toothbrush, flossing after every meal, and mouthwash. But until recently I had a pocket of about 6 millimeters between two of my teeth. Nothing that I did would reduce its depth.

Two of my teeth were too far apart. The only solution, my dentist said, was to replace a crown on one of my teeth with a wider one.

I went for it, figuring that it was only time and money. That, in my book, is a good trade for better blood glucose control through my mouth.

This article is based on an earlier version of my article published by HealthCentral.

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