Diabetes and gum disease: the conversation nobody is having

Plenty of people fight an A1C that will not come down. Clean diet. Right medication. A physician running out of ideas. What sometimes goes unnoticed is a gum infection sitting untreated underneath it all.

Often nobody connects the two. So let us.

Diabetes and gum disease feed each other. The American Academy of Periodontology puts numbers on it: people with diabetes are two to four times more likely to develop periodontal disease, and when they do, it moves faster and takes more bone.

It runs the other way too. Gum disease is a bacterial infection. Infection drives inflammation, and inflammation pushes blood sugar up. Joint reports from the AAP and the European Federation of Periodontology found that moderate periodontitis raises the risk of developing diabetes or making existing diabetes worse. Same fire, two rooms.

Here is the part worth the price of admission: treating the gum infection helps the diabetes. Per the AAP, periodontal treatment has been shown to improve blood sugar levels in people with diabetes. Clear the infection and you remove one of the things driving the numbers up.

The advice for diabetic patients is short. Get a real periodontal exam once a year, not just a cleaning. One with pocket measurements and bone X-rays. The AAP recommends it annually for anyone with diabetes. And build a care team. The AAP advises patients to assemble a periodontist, physician, and other health professionals who work together on both the diabetes and the gum health. Your gums and your blood sugar are one conversation, and your doctors should be having it with each other, not just with you.

A small practical one, straight from the AAP: book morning appointments after a normal breakfast. It keeps your sugar stable through the visit.

If your gums bleed when you brush, do not sit on it. Bleeding is not normal for anyone. For a diabetic it is a flag worth acting on this month, not next year. Gum disease treatment starts with one straightforward exam, and periodontal maintenance keeps it from coming back. (310) 903-7674.

Dr. Sharyar Baradaran, DDS, MS is a periodontist in Beverly Hills and a member of the American Academy of Periodontology, with more than 32 years in practice.