Periodontal disease is caused when the tissues supporting our teeth get infected attacking the gum in our mouth. The gums lose their firmness and a gap, called the sulcus, gets created between the gums and the teeth. The tissues which support our teeth start to break down due to the disease. To cure periodontal disease periodontal therapy is undertaken. It has been found that patients being treated with periodontal therapy need to stop smoking to maintain their oral health and thus, cessation of smoking should be the first step of periodontal therapy. Smoking considerably increases bleeding of the gums if the area undergoing periodontal therapy is probed. Periodontal therapy includes probing and various periodontal attachments and due to smoking the depth of probing could become compromised or the attachments may also be lost. Smokers also show a diminished response to periodontal therapy since it is very difficult to eliminate the sub-gingival pathogens in smokers. (Spring, 2008)
Smoking also causes a hindrance during hard and soft tissue grafting carried out in regenerative therapy. Although, when the patients undergoing periodontal therapy stop smoking, the harmful effects of smoking on their oral health cannot be reversed, yet researchers have proved that the rate with which they lose attachments and bone in their mouth slows down to a certain level after the patients quit smoking. Also, when compared to other smokers and non-smokers, the degree of their disease has been found to be intermediate. It has also been proved that if smoking cessation is viewed as the initial step for successful periodontal therapy then those patients who have quit smoking respond in a similar manner as non-smokers do. Researchers have found the basic reason why smokers do not properly respond to periodontal therapy or why smoking lessens the effectiveness of the outcome of either non-surgical or surgical periodontal therapy. (Matthews, 2002)
The body’s defense mechanism in smokers becomes very weak due to which positive healing responses do not get promoted in their body and they sometimes quit even before their oral surgery since they want to recover quickly. Such patients should understand that smoking has negative effects on periodontal therapy since its advantageous outcomes may be completely undone by their smoking habit. This is because if the patients undergoing periodontal therapy smoke tobacco then certain enzymes are released which causes an increase in the periodontal disease where a bacteria infects the bone, gums and the attachment fibers which provide support to our teeth holding them in our jaw. (Spring, 2008) But when the patients quit smoking not only does the defense mechanism of their body kick back, their oral health also begins to improve as a result of that. Thus patients undergoing periodontal therapy must quit smoking and should also try to brush and floss their teeth regularly since this helps them feel fresh and clean curbing their inner urge to smoke. (Bonnie, 2007)
Diabetes and periodontal disease modulate and exacerbate one another, and thus, each makes the other even more intense. Since the periodontal disease has been found to be more prevalent in diabetic patients than others, we can say that diabetes negatively affects a patient’s periodontal health. The longer a person suffers from diabetes the more susceptible he becomes to oral infections and periodontal disease. (Rees, 2000)The gum tissues of people who do not control diabetes can be affected in two different ways. Firstly, due to diabetes, their blood vessels thicken due to which the supply of nutrients and oxygen to our body tissues gets diminished. As a result, the ability of the body’s immune system gets diminished rendering them unable to fight against infection and the body is open to periodontal disease. Secondly, most of the bacteria which cause various oral infections in our mouth flourish on the excess glucose that can be linked with diabetes. (Matthews, 2002) Diabetic people need to critically perform meticulous plaque control and before their dentists perform any dental surgery on them their blood glucose level should be checked. It has been seen that meticulous plague prevent and control helps to prevent periodontal disease. Patients must daily remove any dental deposit, calculus and plaque, by brushing their teeth to reduce their accumulation. This improves their dental hygiene and reduces the severity of the periodontal disease. (Rees, 2000)
Patients with diabetes should also consider the fact that if they do not control their diabetes and, on top of that, smoke then they are more susceptible to periodontal disease than those who either smoke or have diabetes. Thus, it is up to the patients to care for themselves by maintaining their oral health and checking to have periodontal disease if they are diabetic. People with poor diabetic control are five times more liable to periodontal diseases than those who are not. Not only do they have more attachment loss than others but also if these people have smoking habits then the risk of periodontal disease in them gets increased by almost ten times. (Spring, 2008) Thus, diabetic patients should follow a meticulous oral health care regime and stay far away from smoking if they want to prevent periodontal disease.
References
Bonnie, J R. (2007). Ending the Tobacco Problem: A Blueprint for the Nation. LA: National Academies Press.
Matthews, Debora C. (2002). The Relationship Between Diabetes and Periodontal Disease. Journal of the Canadian Dental Association, 68, (3): 265-274.
Rees, T. D. (2000). Periodontal management of the patient with diabetes mellitus. Periodontol, 23, (1):63-72.
Spring, B. (2008). Smoking Cessation with Weight Gain Control: Therapist Guide. NY: Oxford University Press US.