Effects of Diabetes on Oral Health

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How Does Diabetes Impact Your Oral Health?

More than 30 million Americans (9.4 percent) have diabetes and 84 million live with prediabetes. By definition, diabetes (diabetes mellitus) is a group of serious diseases that result in high blood sugar (glucose). The diseases are typically kept under control with a balanced diet, exercise, insulin, and other medications that control blood sugar levels. There are two types of diabetes, including Type I and Type II:

  • Type I Diabetes — this type of diabetes is often diagnosed in children, adolescents, and young adults. It occurs when the body doesn’t produce enough insulin, which is a hormone that transports sugar from the blood to cells that need it for energy. Type I diabetes is commonly linked to genetics.
  • Type II Diabetes — this type of diabetes is often diagnosed in adults and seniors. It occurs when the body no longer responds to insulin. Being overweight also puts you at a higher risk of developing Type II diabetes.

"In total, over 100 million Americans are living with diabetes or prediabetes."

Centers for Disease Control (CDC)

In 2015, diabetes was the seventh leading cause of death. Heart disease is the leading cause of death, while cancer is the second. This is because people living with diabetes are more likely to develop serious health problems, such as:

  • Heart Disease
  • Stroke
  • Kidney Failure
  • Vision Loss
  • Amputations
  • Mouth Infections & Diseases

Common Dental Conditions Associated with Untreated Diabetes

Symptoms of diabetes can impact many different parts of your body, including the oral cavity. In addition to a higher risk of experiencing general health complications, people with diabetes are also more likely to develop serious oral conditions. This includes infections and pain that can affect your teeth, gums, jaw, tongue, palate, cheeks, or the bottom of your mouth.

Connection Between High Blood Sugar and Plaque Buildup

Glucose is found in saliva, which keeps your mouth wet and helps wash out harmful bacteria. However, when too much glucose is found in your saliva, it encourages the growth of harmful bacteria. Over time, food particles and bacteria result in high levels of plaque, which is a sticky film that forms on teeth. Uncontrolled diabetes and plaque buildup can lead to many serious dental complications, including:

Gingivitis (Minor Gum Disease)

Uncontrolled diabetes commonly causes gingivitis, which is a mild and reversible form of gum disease. It forms due to unremoved plaque and tartar (hardened plaque) that collects above your gum line. Symptoms of gingivitis include swollen, red, inflamed, and bleeding gums. Treatment for gingivitis includes:

  • Professional Teeth Cleanings
  • Fluoride Treatment
  • A Prescription Toothpaste and/or Mouth Rinse

Periodontal Disease (Advanced Gum Disease)

Poor blood sugar control also puts you at a higher risk of developing periodontal disease, also called periodontitis or PD. This is because if gingivitis is left untreated, PD will form. By definition, periodontitis is a serious form of gum disease that causes the gums to pull away from the teeth. As the disease progresses, it can destroy your gums and cause permanent bone loss. Bad breath, changes in teeth alignment, loose teeth, and bleeding gums are all symptoms of PD.

In addition, advanced gum diseases can make your blood sugar rise. As a result, diabetes becomes more difficult to control. You also become more susceptible to infections because your body has a hard time fighting off bacteria that attacks the gums. Lastly, people with periodontitis are more prone to developing type II diabetes or pregnancy (gestational) diabetes.

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Depending on your needs, treatment for PD may include:

  • Scaling and Root Planing (Deep Cleaning)
  • Flap Surgery
  • Bone and/or Tissue Grafts
  • A Combination of Procedures

“22 percent of people living with diabetes develop periodontal disease.”

Dry Mouth & Tooth Decay

High blood sugar reduces the saliva production in your mouth, which causes dry mouth and results in plaque buildup. This condition also increases your risk of tooth decay (cavities) and chronic bad breath. If you have cavities, a dentist may recommend:

  • Cavity Fillings
  • Dental Crowns
  • Dental Implants or Bridges
  • Root Canal Therapy

Oral Thrush

Oral thrush is a yeast infection caused by the overgrowth of Candida fungus. In addition, high levels of glucose make it easier for the fungus to grow. So, diabetics who do not monitor their blood sugar carefully have a higher risk of developing yeast infections. White or red sores and patches on the gums, cheeks, palate, or tongue are common symptoms of thrush. Treatment may include:

  • Antifungals
  • Antiseptics
  • Dietary Supplements
  • Throat Lozenges (Cough Drops)

Oral Burning

Uncontrolled blood glucose levels can also cause a burning sensation in the mouth. Symptoms of oral burning include dry mouth, bitter taste, and burning that worsens throughout the day. Treatment may include:

  • Saliva Replacements
  • Prescription Mouth Rinses
  • Capsaicin (Pain Reliever)
  • Clonazepam (Klonopin)
  • Certain Antidepressants
  • Nerve Pain Blocking Medications

Oral Care Tips for Diabetics

Visiting the dentist at least twice a year for routine teeth cleanings, x-rays, and exams are crucial to ensure your oral health is intact. According to the American Dental Association (ADA), treating gum disease early on helps improve blood sugar control, which decreases the progression of the disease. In addition, practicing good oral hygiene at home helps keep your teeth strong. It also decreases your risk of plaque buildup. This includes brushing twice a day with fluoride toothpaste, flossing regularly, and rinsing with mouthwash each night.

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Resources

“Diabetes, Gum Disease, & Other Dental Problems.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, 1 Sept. 2014, https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/gum-disease-dental-problems.

“Diabetes and Your Smile.” Mouth Healthy TM, https://www.mouthhealthy.org/en/az-topics/d/diabetes.

Lamster, Ira B. Diabetes Mellitus and Oral Health: an Interprofessional Approach. John Wiley & Sons, Inc., 2014.

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Updated on: November 23, 2020
Author
Alyssa Hill
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Lara Coseo
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