Dr. Albert Malakov says he sees a worrying incidence of periodontal disease at his Brooklyn practice and urges diabetic patients to take extra care and never miss check ups.

A recent report from the New York City Department of Health published in 2012 {1} placed the Bronx as the epicenter of diabetes in the US with an astonishing one in three people in the borough suffering from diabetes. Such is the extent of this condition in the US that 20.8 million people or approximately 7% of the population have been diagnosed with this chronic disease. The statistics for the Bronx were alarming: Riverdale and Kingsbridge has 7.3% of the population suffering from diabetes. The Fordham-Bronx Park area reports the incidence of diabetes at 14.6% — the highest in the city.

I have seen the incidence of periodontal disease due to diabetes increase among my patients. The more worrying fact is that according to {2} another report I recently read 30% of the population who have diabetes do not yet know that they have it. It is also a fact that the Chelsea-Greenwich area shows the lowest rate at 4.1 percent.

According to a separate 2013 report the ADA (American Diabetes Association®) has stated that the actual cost of diagnosed diabetic treatment in the USA was $245 billion in 2012, which included $176 billion incurred in direct medical costs. The prevalence of diabetes would cost a further $69 billion in reduced productivity. The huge cost which is between $150,000 and $200,000 per person in 2012 to provide dialysis annually for a single patient with diabetes and kidney disease, will undoubtedly in years to come exert an enormous strain on our health system as it looks like the incidence of diabetes in the US will continue to increase.

The effects of diabetes on periodontal disease.

There is an abundance of evidence these days to support the relationship between periodontal infections and poor glycemic control in diabetic patients. There is also abundant evidence to show {4} the effect of periodontal disease on diabetes mellitus. One study {5} found that the periodontal tissue acts as a harbor for a chronic source of bacteria and a host of inflammatory mediators. These have been found to have an effect on lipids and a patient’s glucose metabolism. They have also reported to be insulin antagonists and can cause insulin resistance. There is undoubtedly a two way relationship between periodontitis and diabetes. Patients with diabetes are at an increased risk for periodontitis and and unfortunately periodontal inflammation has a negative effect on glycemic control.

Therefore with such strong evidence that the link is there it is important that New Yorkers who are diabetic or pre-diabetic see their dentist regularly and if required make an appointment with their periodontist. If you have poor sugar control you have increased chances of getting periodontitis. If you are diabetic your case of periodontitis will be harder to treat and unfortunately you will be prone to losing more teeth.

Dr. Albert Malakov, DDS is a general and cosmetic dentist at Always Smile Dental having owned various practices for 25 years. He gained his degree from NYU. The practice offers dental cleanings, INVISALIGN, dental crowns, dental implants, dental bridges, a periodontist, smile makovers, dentures, emergency dentistry, root canal treatments and all forms of cosmetic dentistry and general dentistry.