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The Diabetes – Oral Health Connection

Mouth Problems Could Signal Diabetes

One in three people with diabetes don’t even know they have it. But untreated, high blood sugar can threaten your heart, blood vessels, eyes, and kidneys. High blood sugar also affects your mouth.

Three oral symptoms could be the first signs that you need to be screened for diabetes:

  • Bad breath. Diabetes is one of several diseases that can cause bad breath. A person with diabetes also may develop fruit-smelling breath. This means the body is struggling to throw off excess chemicals, which could be very dangerous.

  • Dry mouth. People with undiagnosed diabetes may feel especially thirsty. Dry mouth also can cause contribute to bad breath and tooth decay.

  • Sore gums or teeth. Sore, swollen, or bleeding gums could signal the start of gum disease. Gum disease happens more often in people with diabetes. The gums and the bone that holds teeth in place can become infected. If gum disease worsens, the gums could pull away from the teeth. Teeth might look longer or feel sensitive.

Healthy Teeth and Gums: An Important Part of Your Diabetes Management Plan

Everybody likes a bright smile. And keeping your teeth and gums healthy is especially important if you have diabetes. That’s because people with diabetes are at increased risk for a variety of oral health complications, including periodontal (gum) disease, which can damage the gums and bone around your teeth.

The Vicious Cycle

Gum disease may make it harder for you to manage your blood sugar. And poorly controlled diabetes can, in turn, lead to even worse tooth and gum problems. Studies suggest that gum disease also may be linked to other serious health problems, such as cardiovascular disease and stroke.

Gum Disease

The bacteria in your mouth form a sticky, naturally occurring substance called plaque. Plaque builds up on your teeth—especially along the gum line—unless you brush and floss regularly. If ignored, the plaque eventually hardens into tartar, the gritty stuff your dentist scrapes off when cleaning your teeth. Both plaque and tartar can lead to infection in your gums.

Early gum disease is called gingivitis. Gums can become swollen, red, and prone to bleeding. If left untreated, gingivitis can lead to a severe infection of the gums called periodontitis. It can cause the gums to come loose from the tooth root and recede, and the bone that holds your teeth in place to break down. You may notice bad breath, loose teeth, and pus when you press on the gums.

Other Problems

Diabetes makes it easier to get other kinds of mouth infections, too. People with diabetes often have dry mouth. Lack of saliva can lead to tooth decay. Swelling, pain when you chew, or sensitivity to hot, cold, or sweet foods can be signs of tooth decay or infection. White or red patches can signal a fungal infection called thrush. Thrush can be triggered by having high blood glucose, taking antibiotics, smoking, or wearing dentures that don’t fit well.

Chew on These Tips

How can you help keep your teeth and gums healthy? In addition to managing your blood sugar, here are some strategies:

  • Brush your teeth twice a day with fluoride toothpaste and a soft-bristle brush. Use short, gentle strokes, pay special attention to the gum line, and take your time. Brush your tongue, too. Be sure to replace your toothbrush every three or four months.

  • Floss your teeth once a day. Ask your dentist about the proper way to floss. Specially designed dental flossholders make flossing easier.

  • Call your dentist if you notice any of the warning signs of gum disease. These may include red, tender gums that bleed; gums that have pulled away from your teeth; bad breath; or loose teeth.

  • Be sure to get a checkup every six months so that your dentist or hygenist can remove tartar from your teeth and gum line. Tartar harbors plaque, which is a sticky film loaded with bacteria that increases your risk for gum disease. Tell your dentist that you have diabetes.

  • If you wear dentures, have them checked regularly by your dentist.

Smoking also can increase your risk for gum disease, as well as serious diabetic complications, such as nerve damage and heart disease. So, if you smoke, quit. Trying to quit smoking on your own can be difficult, but there is help available through a variety of organizations including the Centers for Disease Control and Prevention (see web site “How to Quit”).

Keeping your teeth and gums healthy is a team effort. But with daily care and regular dental checkups, you can have a bright smile—and keep your diabetes under control.

Your mouth is home to millions of germs. Chronically high blood sugar disrupts the body's immune response to bacteria allowing them to grow. That’s one reason why people with diabetes are prone to getting periodontal (gum) disease. If you have diabetes, you need to take especially good care of your teeth and gums.

Keep Your Smile Bright

Protect your teeth and gums with these simple steps:

  • Keep your blood glucose controlled.

  • Brush your teeth twice a day using fluoride toothpaste. Gently brush all tooth surfaces and along the gum line.

  • Floss at least once a day. Flossing cleans plaque that your toothbrush can’t reach.

  • Get regular dental cleanings and checkups. Be sure to let your dentist know that you have diabetes.

  • Call your dentist if you notice bleeding gums, a swollen or sore area, or pain or sensitivity while eating.

If you need dental work, ask your doctor whether you need to take an antibiotic to prevent infection. While your mouth is healing, keep your blood glucose under control. Talk with your doctor about whether you need to check your blood glucose more often or change your diabetes medication.

Managing Mouth Care with Type 2 Diabetes

People with type 2 diabetes tend to have more problems with their teeth and gums if their blood glucose remains high. The following measures can help protect your teeth and gums from developing oral infections:

  • Get your teeth and gums cleaned and checked regularly.

  • Brush at least twice a day with a soft toothbrush. Pay special attention to the gum line.

  • Floss at least once a day.

  • Call your dentist if you have red, sore, or bleeding gums or a sore tooth.

Remember that it is important to keep your blood glucose at a healthy level. Here are some general tips to help you do just that:

  • Follow your doctor’s dietary recommendations.

  • Don’t forget to take your medicine.

  • Try to exercise at least 30 minutes most days. Consult with your doctor first.

  • Check and record your blood glucose each day.

Traveling might disrupt your routine and affect your blood glucose, so plan accordingly:

  • Arrange ahead of time for a diabetic meal if you’re traveling by plane, train, or ship.

  • Carry extra food with you in case meals are late.

  • Carry twice as much medicine and blood testing supplies as you normally need with you. Keep them in your carry-on bag.

  • Ask your doctor how to adjust your medications, especially insulin, if you’re traveling across multiple time zones.

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