Gum disease and Type 2 diabetes

February is Gum Disease Awareness Month. I want to share with you the importance of taking excellent care of your teeth and gums, especially if you have Type 2 diabetes; this is a very personal issue for me.

an illustration of how gum disease works

I have always had beautiful, strong teeth, partly due to my twice-daily brushing routine and partly due to good genetics. During my college years, I stopped going to the dentist regularly because it was a pain to schedule the appointments and because I never found a practitioner that I liked.

I was a good brusher, so I didn’t worry about not keeping up my dental visits until one day, quite suddenly (or so it seemed), my gums were bleeding and my front tooth was a little wobbly. I still tried to ignore it and hope it would go away, but, much like the Type 2 diabetes I was also ignoring at the time, nothing good comes of burying your head in the sand about gum disease (also known as gingivitis or periodontitis).

Once I’d started dealing with my diabetes and had a better handle on my blood sugar, I decided to deal with the problems with my teeth, so I made an appointment with a local dentist and hoped for the best. Unfortunately, having ignored the early warning signs of periodontitis, I found out that I needed to have 15 of my still-perfect, still-strong teeth removed because the tissue and bone that should have been supporting them had been eaten away by years of untreated infection. If I’d visited a dentist at the first symptoms, I’d probably have saved most, if not all of my teeth; I want you to learn from my mistake.

What are some of the risk factors for developing gum disease?
  • Not following a good dental hygiene regimen, to include brushing twice daily, flossing once each day, and visiting a dentist at least once a year (more frequently if you have any of the risk factors listed below)
  • Family history of gum disease (turns out both of my grandmothers plus my mother all have it although no one ever told me about it)
  • A medical condition that weakens your immune system, like diabetes, HIV/AIDS, or cancer
  • Eating a diet high in processed, sugary foods, which promote the growth of the plaque bacteria that cause gum disease

Some of these are clearly beyond our control – you can’t choose your family – but brushing, flossing, and seeing a dentist are things you can fix right now, and eliminating or limiting processed foods will benefit your health far beyond your gums.

Symptoms of gum disease

So what should you watch for, if you have any of the risk factors?

Normal gum tissue is pink, firm, and stretches around your teeth smoothly without any bleeding when you brush and floss.

In people with gingivitis, gums become red, swollen, and tender. They have a tendency to bleed, too. This should send you straight to your dentist for a chat because things are still very treatable at this point.

Once things progress to full-blown periodontitis (which is what I had), gums will pull away from teeth, your teeth may become loose, and you might experience bad breath and oozing pus. If you are at this point and feel overwhelmed, know that I’ve been in your shoes; you will be OK but time is of the essence. Make an appointment with a dentist or periodontist (if your insurance will allow that) immediately so that you can get things cleaned up and be back on a healthy path.

If the thought of losing your teeth isn’t enough to motivate you to action (and it wasn’t for me, so I’m preaching from experience here) then you need to know that gum disease has been linked to some even scarier health problems, like heart disease, dementia, and rheumatoid arthritis. Scientists haven’t pinned down the precise link but it’s probably related to the inflammatory effect of the uncontrolled bacteria in your mouth. (Inflammation is coming up a lot in the literature I read about many different health conditions.)

Bottom line is that gum disease is highly treatable when caught early and can impact your overall health in less-than-desirable ways if you ignore it, so make an appointment with a dental health professional if you have any of the symptoms.

Knowledge is Power: Eye Exams for Diabetics

effective-diabetes-self-management

The professional support team needed for a person dealing with a chronic disease such as Type 2 diabetes is large. My team includes a primary care physician, an endocrinologist (diabetes doctor), a psychologist, a dentist, a periodontist, and an optometrist. It can feel overwhelming sometimes when I think about all of the visits to these various professionals that are required to ensure that I avoid diabetic complications, if possible, or uncover complications early enough so that they are treatable.

One of the least difficult appointments on my yearly rounds is with my optometrist. Eye exams for diabetics are needed yearly or possibly more frequently if retinopathy is detected by an initial exam. Diabetic retinopathy can be well managed if caught early but sadly many diabetics either do not have access to optometric care or do not know the importance of yearly eye exams for diabetics.

What should you expect at the doctor’s office? Eye exams for diabetics are much the same as for the rest of the population, and should consist of:

  • Glaucoma testing – my doctor uses the “puff of air” test but some doctors use something called a tonometer to touch the front surface of you (numbed) eyes, measuring the pressure inside;
  • Eye muscle movement test – you’ll track moving objects while your doctor watching how your eyes move;
  • Visual acuity test – you’ll be asked to read lines of text that get smaller as you proceed down the chart, while covering each eye in turn;
  • Refraction testing – with that same chart, the doctor will flip back and forth between different lenses, asking you “Which is better?”;
  • Visual field test – the doctor will ask you to keep your head still while tracking how well you can see things at the edge of your visual field (peripheral vision);
  • Retinal examination – after dilating your eyes with special drops, the doctor will examine the back of your eye with a tool called an ophthalmoscope.

My doctor performs the retinal examination as the last item for the appointment; I’m not sure if this is true for all doctors. Since your eyes will be hypersensitive to light and will have trouble focusing properly for several hours after the exam, you should plan to walk to your appointment, ask someone to take you to the office and pick you up afterwards, or find somewhere near the office to sit and wait for the effects to wear off.

Nothing in the eye exam is painful and, when you’re done, it’s a great feeling to know that you can check off another item on the list of required annual appointments for effective diabetes self management.

If you are diabetic, do you have a yearly eye exam? What would you tell another diabetic about why they should have an eye exam as part of their diabetes treatment plan?

p.s. If you’d like to read more about my daily life, visit my personal blog.