Periodontitis: The great danger for diabetics  

Periodontitis: The great danger for diabetics  

Periodontitis is a far-reaching disease, it not only damages our teeth, it affects our whole body. It can be especially critical for diabetics. Read more about it in this blog article by Dr. Roberto Lhotka!



You probably know that sugar is bad for your teeth and oral health, but do you know why?

Sugar contains glucose. Excess glucose in saliva can promote the growth of plaque and thus harmful bacteria in the mouth. This, in turn, can lead to gingivitis, which can progress to periodontitis - a serious infection that damages the soft tissues in the mouth and destroys the bone that supports the teeth. 

For diabetics, the risk is even greater because this chronic disease impairs the body's processing of glucose. As a result, high blood glucose levels can damage blood vessels and nerves, making it even harder to contain the progression of the disease. Thus, the likelihood of simple gingivitis developing into advanced gum disease increases.

What is periodontitis?

Periodontitis, also often referred to as "periodontal gum disease", is a chronic inflammatory disease of the gums caused by bacteria. When bacteria linger too long between or on the teeth, plaque builds up, eventually hardening into tartar if the plaque is not properly cleaned. Periodontitis is also often called periodontosis in common parlance, but what is meant is periodontitis.

There are different stages of periodontitis, ranging from mild to severe. In advanced periodontitis, the gums recede and the bone that holds the teeth is broken down. The periodontium is destroyed, i.e. the fibers connecting the tooth with bone are destroyed.

Gingivitis is the preliminary stage of periodontitis, in which the gums are swollen and slightly inflamed and bleeding may occur. If the cause of the inflammation is not treated, it can develop into periodontitis. 

While gingivitis is limited to inflammation along the gum line, which is usually reversible, meaning it can be reversed, periodontitis can cause irreversible damage such as loss of jaw bone, root cementum and periodontal ligament. 

Dr. Roberto Lhokta talks about periodontitis and diabetes

How does periodontitis develop? The Three Stages of Periodontitis

Periodontitis can be divided into three stages: early, intermediate and advanced. 

Periodontitis - the initial stage

In early periodontitis, the gums begin to recede from the teeth, resulting in periodontal pockets where food, plaque and bacteria accumulate. This causes infections to develop. 

Periodontitis - the middle stage

In moderate periodontitis, symptoms increase as more bone is lost, gums recede, and teeth become loose.

Periodontitis - the advanced stage

In advanced periodontitis, the infection has spread under the gums, leading to painful abscesses and possible tooth loss. 

The severity in which the disease progresses depends on several factors, including:

  • the type and number of bacteria present
  • how healthy the immune defense of the affected person is
  • Presence of risk factors such as diabetes or smoking
  • Genetic factors
  • Certain medications that affect the inflammatory response (e.g., antihypertensive or vasodilator medications).
  • How quickly a treatment is taken up 

Symptoms of gingivitis and periodontitis

To avoid permanent damage to the teeth, gums and surrounding bone, periodontitis is best detected early, preferably while it is still an early stage gum infection. 

Early warning signs of gingivitis include:

  • Recurrent bleeding of the gums when brushing, flossing, or eating 
  • The gums in the affected areas appear red and swollen
  • Sensitive gums
  • Bad breath 
  • Pain at the inflamed site or when chewing
  • Plaque deposits on the underside of the teeth 

Some of the symptoms of advanced periodontal disease are:

  • Loose or wobbling teeth
  • Receding gums or teeth that look "longer
  • Pus between teeth and gums
  • More spaces between the teeth
  • Changes in the way your teeth fit together when you close your jaws
  • Possible tooth loss at an advanced stage

Risk factors for periodontitis

Several factors can increase your risk of developing periodontal disease, including

  • Smoking
  • Genetics
  • Age
  • Type 2 diabetes
  • Stress 
  • the wrong diet. 


Smoking accelerates periodontal disease. In addition, the success rate of periodontal treatments is lower in smokers because the healing process is worse. 

Genetic factors

The genes responsible for building the immune system also influence your predisposition to gum disease. 


Periodontal disease progresses slowly, so that the first signs of gingivitis may appear at age 30, but do not develop into periodontal disease until age 50. With the natural aging process, gums and teeth also change, which means that the consequences of gum disease and the potential for tooth loss are greater with age. 


Type 2 diabetes is another important risk factor for periodontitis. If blood sugar is not well controlled, there is a higher potential for the development of periodontitis. Interestingly, there is a reciprocal effect between periodontitis and diabetes. Uncontrolled blood sugar can lead to periodontitis, and periodontitis can increase the risk of diabetes. We will discuss the relationship between periodontitis and diabetes in more detail in the next section. 

Unhealthy diet

Auch die Ernährung ist ein Faktor für Parodontitis. Eine Ernährung mit einem hohen Anteil an raffinierten Kohlenhydraten und industriell verarbeiteten Lebensmitteln kann das Risiko einer Zahnfleischentzündung erhöhen. Eine ungesunde, zuckerhaltige Ernährung kann auch das Risiko für die Entwicklung von Typ-2-Diabetes erhöhen, was die Wahrscheinlichkeit einer parodontalen Zahnfleischerkrankung steigert. Lesen Sie hierzu auch meinen Blog-Artikel über Zucker: Hier


Stress can weaken the immune system, making it harder to fight off gum infections, which means that the infection can develop faster than the immune system can cope. In addition, people who are stressed or mentally ill are less likely to pay attention to their oral hygiene. 

The connection between periodontitis and diabetes

There is a close connection between periodontal gum disease, especially periodontitis, and diabetes. People with diabetes are more likely to develop periodontitis. It has also been shown that periodontitis can make it difficult to control blood glucose levels. This is partly because the inflammation caused by periodontitis can impair the body's ability to use insulin, the hormone responsible for regulating blood glucose levels. 

In addition, diabetes changes the quality and composition of saliva, which plays an important role in oral health. Saliva lubricates the mouth and washes away food particles, protecting tissues and preventing the growth of bacteria. People suffering from diabetes often produce less saliva, resulting in a dry mouth, and their saliva may have a higher glucose content. This promotes the formation of plaque, or dental plaque, and the growth of bacteria. This in turn leads to an increased risk of periodontitis.

In addition, high blood sugar levels can slow down the healing process of gingivitis, giving it more time to spread and cause damage below the surface. 

If your dentist or dental hygienist diagnoses you with periodontitis, you should additionally ask your family doctor/family physician to measure your blood sugar level. Conversely, it is important to tell your dentist that you suffer from diabetes, so that the health of your gums can be kept especially in mind. In fact, the way of treatment depends on it.  

Treatment of periodontitis in diabetes

Treatment of periodontal disease and diabetes is most effective when detected early. If it has been determined that you may be pre-diabetic, simple lifestyle changes may be enough to bring your blood sugar back under control. However, if you have been officially diagnosed with diabetes, you may need medication to control your blood sugar.

The same applies to periodontitis. Gingivitis or gingivitis in the early stages is easier to treat than periodontitis, which may require more invasive procedures and cause long-lasting damage. Seek detailed advice from your treating dentist and always point out your diabetes condition, as this is a decisive factor in drawing up the treatment plan.

Studies show that treating periodontitis can lower blood sugar levels in diabetics. Therefore, it is important to treat the disease quickly to avoid further diabetes-related complications.

Can periodontitis be cured?

In patients suffering from both periodontitis and diabetes, good blood glucose control can significantly contribute to the healing and prevention of periodontitis. 

Of course, good oral hygiene and regular visits to the dentist are the best way to prevent gingivitis from developing into periodontitis. 

The goal of periodontal treatment is to reduce swelling and inflammation in order to stabilize the bone and gums. 

How can periodontitis be treated?

Depending on how advanced the periodontitis is, various non-surgical or surgical treatments may be used.

Non-surgical treatment may involve antibiotics, scaling or root planing. I personally try to avoid the use of antibiotics, as they unbalance the oral biome and often provide short-term improvement, but at the same time long-term worsening of the disease. As an alternative, I have developed Dr. Lhotka Vienna Organics Organic Tooth Oil Concentrate, which I have been using successfully in my office for many years.

However, in any case, as one of the first steps, gum removal is necessary. Tartar removal involves removing tartar and bacteria from the tooth surfaces and under the gums using a laser or ultrasonic device. Root planing involves smoothing the surface of the tooth roots to prevent further accumulation of bacteria and tartar. 

Surgical intervention may be required for advanced periodontitis. Depending on the condition, this may include surgical pocket reduction, soft tissue or bone grafting, guided tissue regeneration, or application of a tissue-stimulating protein gel to the decayed area to promote bone and tissue growth. In many cases, the minimally invasive pin-hole technique, which I have been practicing for many years as the only physician in Austria, can help. 

Holistic lifestyle tips to reduce the risk of periodontitis

Gum inflammation and disease can be easily prevented by adopting healthy lifestyle habits and going for regular check-ups or preventive examinations. Below you will find some tips for the treatment and prevention of gingivitis.

A good oral hygiene routine as the basis of dental health

Good oral hygiene is important to reduce the risk of periodontitis. 

  • Brush your teeth twice a day
  • Use dental floss every day
  • Choose a soft toothbrush and change it every three months or as soon as the bristles bend.
  • Use a mouthwash or mouth rinse after brushing your teeth
  • Go regularly to professional dental cleaning / oral hygiene
  • If you feel that your gums are inflamed, see your doctor immediately. 
  • If you smoke: stop immediately

Please also read my blog post on the correct tooth brushing technique!

Use my organic dental care products 

I have been a dentist for several decades and therefore know the problem of finding the "right" dental care. That's exactly why I developed an organic tooth care series, because I wanted a toothpaste that prevents, cares and heals.

In my products, I place great emphasis on high-quality, effective and natural products that help you optimize your oral health. The dental care products contain herbal ingredients such as cinnamon, cloves, lemongrass and thyme, which provide effective protection against inflammation and harmful bacteria. 

Dr. Lhotka Vienna Organics Organic Toothpaste: 

The highly effective herbs and essential oils heal and protect the gums, harmonize the oral flora and have a lasting effect against bad breath. 

Dr. Lhotka Vienna Organics Organic Mouthwash: 

The naturally antibacterial properties of the herbs and essential oils in this formula promote faster healing of inflammation in the mouth, help with bleeding gums and freshen breath. Mix a few drops in a cup of water, rinse for 30 seconds and spit out.

Dr. Lhotka Vienna Organics Organic Tooth Oil: 

This dental oil concentrate can be applied to dental floss and used after brushing - because of the concentration, just a few drops are enough! 

Control your blood glucose level 

  • If you have diabetes, measure blood glucose levels regularly
  • Drink plenty of water (2-3 liters per day)
  • Eat a healthy diet rich in vegetables, protein and fiber and low in sugar
  • Avoid processed foods and refined carbohydrates
  • Add a spoonful of apple cider vinegar to a glass of water and drink it before meals
  • Regular exercise - walks after meals are especially good for balancing blood sugar levels.

Leave a comment

Please note that comments must be approved before publication