diabetes mellitus

Diagnosis and treatment of periodontitis in diabetes mellitus

Diabetes mellitus leads to pathological changes in the structure of blood vessel walls. Vascular pathologies associated with the disease result in impaired blood supply to various organs and tissues, including the periodontal tissues. This decreases the resistance of the gums to infections. An additional trigger for the development of this condition is the high glucose content in the saliva, which provides an ideal environment for the proliferation and activity of pathogenic bacteria. Let’s consider the main symptoms of this condition:

  • xerostomia (disruption of saliva production, dryness in the oral cavity);
  • bleeding during tooth brushing;
  • bleeding even with minor pressure (chewing, pressing);
  • destruction of connective tissue between the gums and tooth;
  • formation of gaps between teeth;
  • pus discharge from the subgingival area;
  • unpleasant breath and an unpleasant taste;
  • mobility and loss of teeth.

During the examination, a periodontist first visually assesses the state of the patient’s oral cavity. For a more detailed study of the disease, PSR (Periodontal Screening and Recording) diagnostics may be used, which allows the doctor to obtain a comprehensive understanding of the nature of inflammation, the degree of damage of the gum tissues, teeth, connective tissue and jawbone.

Gum diseases can sometimes be asymptomatic, so people with high blood sugar are advised not to ignore the presence of blood in saliva during hygiene procedures. Such a minor symptom may signal the onset of a serious destructive process in the periodontal tissues. If you notice signs of bleeding, promptly schedule a consultation with a doctor.

Treatment of gum diseases in diabetic patients is complicated by their increased tooth sensitivity and reduced body resistance. Healing of tissues and recovery after any intervention occurs very slowly, and without proper therapy, the infection can quickly spread from the gums to the tissues responsible for the stable attachment of the tooth to the jawbone. Treatment of the gums in diabetic patients is carried out during the compensation stage and therapeutic measures include:

  • Vector therapy.

This is a gentle method of plaque removal using ultrasound, which cleans periodontal pockets without damaging the soft tissues and polishes the roots without causing harm.

  • Laser therapy.

This type of therapy has a disinfecting effect, improves blood circulation and stimulates tissue regeneration. Laser treatment of the gums and sterilization of pockets yields noticeable results at any stage of periodontitis, reducing or completely eliminating signs of inflammation.

  • Restoration of normal microflora.

Normalization of the microflora ensures prolonged remission. Probiotics used in this treatment method inhibit the growth of periodontopathogens, enhance the activity of antibacterial enzymes, and stimulate local immunity.

The treatment planning for the gums is developed based on the nature and stage of the inflammatory process, as well as considering the overall health of the patient in collaboration with an endocrinologist. During various procedures, it is important to continue taking medications to normalize blood sugar levels according to your type of diabetes. For example, in type 2 diabetes, medications such as Accarb, Amaryl M and Amaryl may be prescribed. Therefore, it is crucial to consult with an endocrinologist before any treatment, as they will help determine the correct dosages of medications during periodontal care.