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Periodontitis

Publication Date: 2/26/2005

This webpage is part of a series about detection and prevention of periodontal disease in diabetes

 
The response to plaque leads to progressive destruction of the connective tissue fibers, resorption of the alveolar bone around the tooth, and deepening of the gingival sulcus or socket. The resulting condition is called periodontitis.

 

Illustration and photograph of gum line with severe periodontis

 

The periodontium--the tissues surrounding, supporting, and attaching to the teeth--is affected by the toxicity of bacterial plaque as well as the resistance of the tissue. The microvasculature of the periodontium in diabetes shows microangiopathic changes that may reduce the resistance of the tissue and allow more severe periodontal disease. If untreated, periodontitis may result in rapid destruction of the tooth support and eventual tooth loss.

 

Illustration of progression of periodontis

 

This is a periodontal abscess between the lower front teeth in a person with diabetes. An increased susceptibility to acute periodontal abscesses has been reported in uncontrolled diabetes mellitus.

 

Photograph of periodontal abcess in person with diabetes mellitus

 

Periodontal abscesses also occur in individuals without diabetes, but their presence should alert the examiner to the possibility of undiagnosed diabetes or a change in diabetic control.

 

Photograph of periodontal abcess in person with diabetes mellitus

 

This is gingival granulation tissue on the side of the tooth. Such granulomatous growths from the wall of the gingival sulcus result from periodontal disease.

 

Photograph of gingival sulcus, resulting from periodontal disease

 

This is submerged gingival granulation tissue in the wall of a periodontal pocket. This gives the gingiva a magenta or violet color as compared to the normal adjacent periodontium. Abscesses and granulation tissue occur in all persons with periodontal disease but are exaggerated in patients with diabetes. When they occur, blood glucose tests are indicated.

 

Photograph of submerged gingival granulation tissue in the wall of a periodontal pocket.

 

This is a periodontal abscess in a person with NIDDM of 8 years' duration.

 

Photograph of periodontal abcess

 

Mouth of the same individual shows severe edema of the palatal tissue and granulation. Note the deep magenta color of the gingiva close to the tooth as compared to the pink of the palate.

 

Photograph of palate tissue and granulation in patient with advanced periodontal disease

 

Oral hygiene measures--prophy and scaling--carried out by professionals are extremely important in controlling periodontal disease. This slide shows an individual with newly diagnosed NIDDM prior to oral debridement.

 

Mouth of patient with NIDDM prior to treatment

 

One week after treatment, a decrease in inflammation is apparent at the margin of the gum. A dramatic response can occur in a short time with professional removal of calculus and plaque and diligent daily home care.

 

Mouth of patient with NIDDM after treatment

 
From the National Institute of Dental and Craniofacial Research
Detection and Prevention of Periodontal Disease in Diabetes
June 1994
http://www.nohic.nidcr.nih.gov/pubs/perdiab/perio/
 

Also see

other webpages about teeth and periodontal disorders


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