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Kay Knowles: Arresting gum disease
Kay had to start looking after her gums to improve her oral health
As a child and teenager Kay Knowles had perfect dental health. She had such good teeth she thought she didn't need to look after them. It took the sudden onset of gum disease to motivate her to take good care of her gums and teeth.
Kay, who lives in Christchurch, was diagnosed with Type 1 diabetes in 1975. She was on two injections a day in an effort to manage her diabetes. In her work as a nurse, shift work made good diabetes management more difficult.
None of the health professionals Kay visited appreciated how difficult it was for her to manage her diabetes. They did not seem to believe that good self-management could be difficult. Trying to keep to her diet, test her blood glucose regularly and adjust her insulin accordingly was not enough. Kay stopped seeing health professionals, except for visiting the doctor for prescriptions.
Kay had always had perfect dental health. When she was a teenager her dentist said 'You have never had any fillings and you never will.'
As a child and teenager Kay had always brushed her teeth two to three times a day and taken fluoride tablets. But after she left school, she no longer visited the dentist for a check-up. Her teeth brushing became less regular. She did not forget her dentist's words to her as a teenager. She thought that because she had such good teeth, she did not need to look after them. Nor did she realise the importance of looking after her gums.
Kay began to notice her gums were bleeding when she brushed her teeth. Her gums were occasionally painful. Her teeth even became a little loose. But she thought that was normal.
One morning, Kay got a fright. She noticed pus between two of her bottom teeth. Immediately she made a dental appointment.
The dentist told Kay she had gum disease and she needed to see a periodontist. The periodontist told her that her gums had become diseased and had begun receding, hence the loose teeth. The periodontist also said that people with diabetes are especially prone to getting gum disease if they have high blood glucose levels.
Kay had to endure some unpleasant visits to the periodontist. She also had to begin looking after her gums. This included brushing her teeth with an electric tooth brush twice a day and cleaning between her teeth with tiny brushes. She had been dental flossing occasionally but now that was not sufficient. The gaps between her teeth had become much wider due to her gums having receded.
Kay now visits a dental hygienist every four months and the dentist every six months. The bleeding between her gums has stopped. Her gum erosion has been arrested.
Another reason that Kay's gums have not continued to deteriorate so rapidly is that her diabetes management has improved since she has been on an insulin pump. When insulin requirements change at certain times during the day the pump enables her to adjust insulin doses accordingly. Multiple finger pricking is the only way to keep track of her constantly changing blood glucose levels.
The insulin pump is not the only reason Kay has improved her diabetes management. The health professionals she visits are now supportive and understanding because much more is known about diabetes.
© Diabetes New Zealand Inc. November 2006