Whether you or someone you love have lived with diabetes for years or were recently diagnosed, you know that diabetes can affect the entire body. From issues impacting eyesight to circulation in the toes, diabetes doesn’t seem to leave any bodily system untouched. But did you know that diabetes also affects the health of your mouth, teeth, and gums?
Diabetes and the Body-Mouth Connection
The body and mouth are connected. When illness impacts one, it also impacts the other. Even when well-controlled, diabetes increases the risk of developing certain dental diseases. These risks increase as blood sugar rises and diabetes gets more difficult to manage and becomes uncontrolled diabetes. Uncontrolled diabetes contributes to the development of cavities, gum disease, and other oral health complications, including tooth loss. According to research published by the American Dental Association, one in five cases of total tooth loss is linked to diabetes1.
While this sounds very grim, the good news is that the body-mouth connection works both ways. Improving your oral health can help improve your overall health. The right dental care treatment and daily at-home care routines can help you take charge of your oral health and better control your diabetes at the same time.
Diabetes, Blood Sugar, and Your Mouth
Blood sugar (blood glucose) management is the number one day-to-day concern for people living with diabetes. While you may be intimately familiar with your glycemic index at any given time, you might not realize the impact high blood sugar has on oral health2. How? It starts with saliva. When blood glucose is high, glucose levels in saliva rise too.
Uncontrolled diabetes makes it harder for your body to heal and fight infection. Increased sugars in saliva combined with a lowered ability to fight infection create the perfect environment for a fungal infection called oral thrush (candidiasis) to develop. Oral thrush causes painful patches of growth in the mouth, on the cheeks, tongue, or throat3.
High blood sugar from uncontrolled diabetes impacts teeth too. Increased sugars in saliva feed the bacteria that naturally exist in your mouth, increasing plaque production. This sticky film of bacteria releases acids that attack your teeth and lead to cavities.
As cavity-causing plaque builds up, it hardens into tartar (which can only be removed by an MDA dentist or dental hygienist). If left untreated, tartar build-up and cavities can cause further complications. In those with uncontrolled diabetes, these can happen fast—even between routine visits to an MDA dentist—and make managing diabetes more difficult.
DID YOU KNOW?
The link between advanced gum disease (periodontitis) and diabetes goes both ways: one disease impacts the development of the other. Having advanced gum disease increases the risk of developing diabetes4.
The Diabetes–Gum Disease Link
From causing sickly sweet breath to yellowing tooth enamel, high blood sugar and diabetes-related inflammation can quickly lead to bigger problems in your mouth: gum disease.
Those with diabetes are up to three times more likely to develop advanced gum disease (periodontitis) than those without diabetes5. The less under control your diabetes is, the more at risk you are for developing gum disease.
- Gingivitis is the earliest stage of gum disease. Changes in your mouth along with diabetes-related inflammation in the gums cause gum tissue to pull back and expose teeth. This leaves you at greater risk for cavities, oral infections, and tooth loss. Early treatment from an MDA dentist’s team and good daily at-home routines can help prevent gingivitis from advancing.
- Periodontitis is an advanced form of gum disease. It causes severe deterioration of gum tissue, increased oral infections, jawbone loss, and total tooth loss. This disease often takes hold as diabetes advances and gets worse as blood sugar gets harder to control6. This stage of gum disease requires extensive treatment from an MDA dentist or MDA periodontist.
As destructive as it can be, gum disease impacts more than your mouth. Just as increased blood sugar levels contribute to gum disease, the inflammation caused by gum disease has been proven to interfere with blood sugar levels. This makes it harder to control your daily blood sugar levels, making uncontrolled diabetes even worse. This is the diabetes-gum disease link. It may not be possible to break, but it can be managed with the right dental care intervention7.
Diabetes-Related Gum Disease Prevention Tips:
Prevent gum disease from derailing your health with regular visits to an MDA dentist. Then, stay proactive at home by adopting healthier habits such as quitting smoking and following an MDA dentist-approved daily oral care routine.
Diabetes and Dental Care: Visiting an MDA Dentist
Treating diabetes-related gum disease and oral health issues is possible with the help of an MDA dentist and their dental care team. Improving your oral health allows you to better manage your diabetes. If you haven’t been to a dentist in a while, schedule a visit! Your MDA dentist wants to help you get back on track for diabetes management and your overall well-being.
Here’s what you can expect from your appointment with an MDA dentist and their team:
- Tell your MDA dental team about your diabetes diagnosis and any recent illness-related symptoms or complications—even if they don’t occur in your mouth. That includes issues with wound healing or difficulty with daily blood sugar regulation.
- Share your latest A1C level with your dental care team. This figure provides insight into the long-term state of your diabetes and helps your MDA dentist evaluate how at-risk you are for certain complications.
- MDA dentists look for changes in your health from one visit to the next. Depending on your oral and overall health, your MDA dentist may want to see you more frequently than every six months to treat illness or monitor changes in your mouth, teeth, and gums.
- Ask questions. It’s always okay to ask questions! Your MDA dentist and their team are here to listen with compassion, provide informed advice, and help you on your journey to improved oral and overall health.
- Tip: Avoid scheduling appointments that conflict with your regular meal times. Take your blood glucose before your appointment and share that number with your dental care team. They may check it again when you arrive.
A visit to your MDA dentist is a great first step in taking charge of your oral health—and learning what you can do to keep it—and your diabetes—in check.
Find an MDA Dentist Near You
Don’t have a dentist? Use our Find a Dentist tool to find an MDA dentist in your area. At your next appointment, talk to your dentist about your diabetes—for the sake of your oral and overall health!
Diabetes and Access to Dental Care:
MDA dentists are here for you because we know dental care is essential for diabetes management. If you’re concerned about cost or access to care, talk to your MDA dentist about your options. You may qualify for free or reduced-fee treatment through a local community dental program.
- Patel M, Kumar J, Moss M. Diabetes and Tooth Loss: An analysis of data from the National Health and Nutrition Examination Survey, 2003-2004. Journal of the American Dental Association. May 1, 2013; 144(5):478-485. Accessed online: https://jada.ada.org/article/S0002-8177(14)60491-8/fulltext
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and National Institute of Health (NIH): Diabetes, Gum Disease, & Other Dental Problems. NIDDK/NIH; 2014. Accessed online: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/gum-disease-dental-problems
- The Mayo Clinic. Oral Thrush. Mayo Foundation for Medical Education and Research (MFMER); April 23, 2021. Accessed online: https://www.mayoclinic.org/diseases-conditions/oral-thrush/symptoms-causes/syc-20353533the
- Preshaw P, Bissett S. Periodontitis and diabetes. British Dental Journal. 2019; 227(7):577-584. Accessed online: https://www.nature.com/articles/s41415-019-0794-5
- Mealey et al. in Preshaw P, Bissett S. Periodontitis and diabetes. British Dental Journal. 2019; 227(7):579. Accessed online: https://www.nature.com/articles/s41415-019-0794-5
- Graziani et al. in Preshaw P, Bissett S. Periodontitis and diabetes. British Dental Journal. 2019; 227(7):577-584. Accessed online: https://www.nature.com/articles/s41415-019-0794-5
- Poudel P, Griffiths R, Wong V.W, et al. Oral health knowledge, attitudes and care practices of people with diabetes: a systematic review. BMC Public Health. 2018;18:577. Accessed online: https://doi.org/10.1186/s12889-018-5485-7
Additional Sources Consulted:
Centers for Disease Control and Prevention (CDC). Fact Sheet, Take Charge of Your Diabetes: Healthy Teeth. Accessed online: https://www.cdc.gov/diabetes/library/factsheets/diabetes-and-healthy-teeth.html
Martin L. Diabetes and Your Smile. Mouth Healthy Blog American Dental Association (ADA). Accessed online: https://www.mouthhealthy.org/en/az-topics/d/diabetes
Michigan Department of Health and Human Services (MDHHS). Oral Health and Diabetes Fact Sheet. MDHHS; January 2017. Accessed online: https://www.michigan.gov/documents/mdch/Oral_Health_and_Diabetes_Fact_Sheet_Epi_complete_418639_7.pdf
National Institute of Dental and Craniofacial Research (NIDCR) & National Institute of Health (NIH). Diabetes & Oral Health. NIH/NIDCR; 2018. Accessed online: https://www.nidcr.nih.gov/health-info/diabetes