The Relationship Between Diabetes & Oral Health

Dr. Reza Written by Dr. Reza Khazaie

Understanding diabetes and oral health

Diabetes isn’t a choice, but we can choose the best strategy to fight it, especially when it comes to your dental health.

Nearly 30 million people battle diabetes, and every 23 seconds, someone new is diagnosed with diabetes.

Facts about diabetes and oral health

The Relationship Between Diabetes & Oral Health

Here are some key facts about diabetes and oral health:

  • People with diabetes are at higher risk for oral health problems like gum disease, tooth decay, dry mouth, fungal infections, and poor wound healing.
  • High blood sugar levels can create an environment in the mouth that allows bacteria to thrive. This can exacerbate gum disease.
  • Those with diabetes may have a decreased flow of saliva, causing dry mouth, which can lead to tooth decay and other oral infections.
  • Poor blood sugar control makes it more difficult for the body to fight off infections and heal wounds in the mouth.
  • Gum disease may make it more difficult for people with diabetes to control their blood sugar levels. Inflammation from gum disease can increase insulin resistance.
  • Practicing good oral hygiene through brushing, flossing, and regular dental cleanings is extremely important for those with diabetes to help prevent oral health complications.
  • People with diabetes should have dental checkups and teeth cleanings at least twice a year to monitor their oral health closely. More frequent visits may be needed if gum disease is present.
  • Maintaining optimal blood sugar levels and working closely with dental professionals can help those with diabetes reduce their risk for oral health problems.
The connection between diabetes and oral health

Diabetes and oral health conditions are often related, according to the National Institute of Dental and Craniofacial Research. Patients with Type I or Type II diabetes are at an increased risk of developing tooth decay, gum disease, dry mouth, and various fungal infections in the mouth.

Fortunately, people with diabetes today can take a proactive approach to managing their oral health by following and controlling their glucose levels, practicing thorough oral hygiene, and visiting the dentist regularly for examinations and dental cleanings is important.

Understanding Diabetes and Oral Health - Best dentist in Concord, CA

Oral health issues of uncontrolled diabetes

The immune system can easily become impaired when diabetes is not controlled. People with diabetes face a higher risk of oral health problems, such as:

1. Thrush

Those with diabetes who often take antibiotics to fight various infections in their body are most prone to developing a fungal infection of the mouth or tongue. The fungus thrives on the increased glucose levels in the saliva of people with uncontrolled diabetes.

Wearing dentures, especially if worn continually can be a great contributor to fungal infections.

People with diabetes who smoke are a much higher risk — up to 20 times more likely than non-smokers to develop thrush and periodontal disease. Smoking also is believed to impair blood flow to the gums, which could negatively impact the healing around the tissue or wound areas.

2. Burning mouth

A burning sensation in the mouth or tongue is caused by the presence of “thrush.”

3. Dry mouth

Unmanaged diabetes will often decrease saliva production which is the body’s way of naturally rinsing the mouth of harmful bacteria, resulting in dry mouth. Dry mouth, if untreated leads to infections, tooth decay, ulcers, and soreness in the mouth, jaw, and sinus cavity.

4. Periodontitis, gingivitis (gum inflammation)

Another complication of diabetes if left unchecked is the weakening of white blood cells which results in the thickening of blood vessels. This results in slowing the flow of nutrients to and waste products from the body tissues, including the mouth. This combination of events makes it difficult for the body to fight off infections.

Since periodontal disease is a bacterial infection, people with uncontrolled diabetes might experience more frequent and more severe gum disease.

5. Gum infection

Research also indicates that having a severe gum infection can make it much more difficult for diabetics to control blood sugar levels. If blood sugar is poorly managed, it is more likely that other oral health problems will arise.

6. Insufficient healing of oral tissues

Uncontrolled diabetes in a person can be a detriment to the proper healing of the oral tissues from dental treatments or oral surgery. This is due to the lack of blood flow to the surgical or area of therapy.

Are people with diabetes at a greater risk for dental cavities?

There are some who argue that elevated levels of glucose in the saliva of individuals with uncontrolled diabetes create a favorable environment for bacterial proliferation. Consequently, this leads to the emergence of gum disease and dental caries.

What is dental caries?

Stages of Dental Caries Development - Willow Pass Dental Care - Concord, CA

Dental caries, also known as tooth decay or cavities, is the breakdown of teeth due to acids made by bacteria. Here are some key facts about dental caries:

  • It’s caused by oral bacteria like Streptococcus mutans that feed on sugar and starch in the mouth and produce acids that degrade tooth enamel.
  • The acids dissolve through the enamel and cause tiny holes or cavities to form. If untreated, caries can progressively get larger and affect deeper layers of the tooth.
  • Caries can occur on tooth surfaces between teeth, inside pits and fissures, and around old dental work.
  • Risk factors include poor oral hygiene, frequent snacking on sugary or starchy foods, dry mouth, worn fillings, and not getting enough fluoride.
  • Symptoms can include pain, sensitivity, bad breath, and dark spots on teeth. More advanced caries may have no symptoms until the tooth fractures.
  • Dental caries is one of the most common chronic diseases worldwide. Both children and adults can get caries.
  • Early detection through dental exams and X-rays allows for preventive strategies like fluoride and sealants before cavities develop.
  • Treatment depends on the extent of decay, but may involve fillings, crowns, root canals, or tooth extraction and replacement.
  • Good oral hygiene and limiting sugary foods can prevent new caries. Fluoride, dental sealants, and oral probiotics may also help.

Additionally, individuals with diabetes often consume food more frequently throughout the day, thereby augmenting the likelihood of bacterial growth and the occurrence of cavities.

Dental Cavities vs. Caries - Concord, CA Dentist

Some argue that individuals with diabetes have a heightened awareness regarding sugar management, leading them to consume fewer cavity-causing sugary foods.

Maintaining proper oral hygiene and a balanced blood sugar level are essential for protecting against cavities and periodontal disease.

What actions should individuals with diabetes take to maintain the health of their oral cavity and gums?

Given the heightened susceptibility of individuals with diabetes to infections and oral health issues, it is crucial to uphold proper oral hygiene practices and promptly address any oral health changes. Should any alterations arise, it is imperative to immediately seek dental attention.

11 Recommendations to Reduce and Prevent Oral and Dental Health Issues

Following are my recommendations to reduce or even prevent oral and dental health issues:

  1. Postpone non-emergency dental procedures if your blood sugar is not in good control. However, severe infections, such as tooth abscesses, are a dental emergency and should be treated immediately.
  2. Make your dentist aware of your condition. Provide your dentist with your doctor’s name and phone number. This will allow your dentist to readily contact your doctor regarding treatment or questions.
  3. Before scheduling treatment for periodontal disease, see your doctor first.
  4. Keep your blood sugar as close to normal as possible. Make sure you take the initiative to inform your dentist of the status of your diabetes.

    For example, know your glycosylated hemoglobin (HgA1C) level. (Good control is indicated by a level under 7 percent). If you’ve had an incident of low blood sugar (also called an insulin reaction) in the past, you are at increased risk of having another one. Tell your dentist when your last occurrence was, how frequently such incidents occur, and when you took your last dose of insulin (if you take insulin).
  5. Provide a list of the names of all the medications and the amount of dosages you are taking. This will be beneficial to the dentist in prescribing medicines least likely to interfere with the medicines you are taking.
  6. Follow carefully the treatment prescribed by your dentist. Keep in mind that healing might take longer due to diabetes.
  7. For those with braces, call your orthodontist immediately if a wire or bracket cuts your tongue or mouth. Make sure to remind them you are a diabetic so that this is elevated and addressed immediately.
  8. It is important to have regular dental check-ups and teeth cleanings at least twice a year to maintain good oral health.
  9. If you wear dentures, make sure to remove and clean them daily. Check out our comprehensive guide to dentures.
  10. Prevent plaque buildup on teeth by using dental floss at least once per day. Please read Dr. Reza’s article about The Top 7 Flossing Tools for Healthier Teeth and A Beautiful Smile.
  11. If you smoke, talk to your doctor and find a plan together that helps you quit.

Diabetes is a disease that can affect the entire body — your eyes, heart, nerves, kidneys, and your teeth, gums, and mouth. With attention to medical care, awareness, and self-care that monitors and keeps blood sugar as close to normal as possible, and excellent personal and professional dental care, problems after dental treatments or oral surgery are no more likely in people with diabetes than in those without the disease.