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2017-12-20

Diabetes and Dental complications

Summary

Studies suggest that people with poorly controlled diabetes are at a significant risk for dental issues. They are more likely to face gum problems like infections along with bone problems since diabetes can reduce the blood supply to gums. Having high sugar can also cause dry mouth, and make the gum infection worse. Less saliva, causing dry mouth can allow more tooth-decaying bacteria and plaque build-up. Therefore, with good blood sugar control and dental care, one can easily avoid these problems. Additionally, it is a must to inform your dentist if you have either new-onset or a long standing diabetes history which might affect your dental treatment, as well as give an idea as to how often teeth examination ought to be done.

How diabetes affects the mouth

Excess sugar/ glucose in the blood from diabetes can cause pain, infection as well as other problems in the mouth. Saliva contains glucose, and when diabetes is not at check, high glucose levels can aid the growth of harmful bacteria. They combine with food to form a soft, sticky film called plaque. Plaque build-up is also caused due to consuming foods that contain sugars or starches. Some plaque cause tooth decay and cavities, whereas other plaque cause gum disease and bad breath. It takes longer to heal gum diseases especially if you have diabetes, and in turn can make the blood glucose difficult to control.


Symptoms of dental health problems

1. Sore/ swollen gums

2. Receding gums

3. Bad breath

4. Loose teeth

5. Bleeding gums

If these symptoms are experienced, urgent treatment might be needed.

Gum diseases to look out for -

Consistent high blood glucose levels can increase the risk of oral health problems like gum diseases. Also known as periodontitis, it is the sixth most common disease in the world which happens when bacteria in the mouth begins to form a sticky plaque which sits on the surface of the tooth.

There are 3 stages of gum disease-

Gingivitis: Gingivitis is the initial stage of gum disease, caused by poor oral hygiene and irregular plaque removal from teeth. It is characterised by swollen, red and tender gums and it can cause bleeding when brushing. Luckily gingivitis is reversible, and through improving your oral hygiene techniques and visiting your dentist or hygienist for advice on a home dental health care program, you should be able to reverse this process

Periodontitis (Mild): Untreated gingivitis can lead to mild periodontitis. The conversion of gingivitis to periodontics is more common in people who have a family history of gum disease, poor oral hygiene and uncontrolled diabetes. At this stage there will be damage to the gums and bone supporting the teeth. In order to prevent further damage a prompt visit to the dentist is required to prevent further progression

Periodontitis (Severe): This is the most advanced stage of gum disease, characterised by significant tissue and bone loss around the teeth

Additionally, people might also develop Thrush which is a fungal infection that can occur in the mouth, sometimes secondary to dry mouth, following a course of broad-spectrum antibiotics. People with poor sugar control are more likely to develop thrush. Signs include white patches within the mouth, redness of tongue and cracking of skin at corner of lips

How to tackle the problem?

  1. Quit smoking. Looking at how smoking affects the mouth badly, it raises the chances of getting gum disease, oral and throat cancers, oral fungal infections etc. It also discolours your teeth and makes your breath smell bad. Smoking and diabetes are a dangerous mix since it can raise the risk for many other diabetic problems. If you quit smoking,

• You'll lower your risk of heart attack, stroke, nerve disease, kidney disease, and amputation.

• Your cholesterol and blood pressure levels will improve

• Blood circulation will improve.

2. Keep your blood glucose numbers as close to target as possible.

3. Eat healthy meals and follow it after working them out with your doctor or dietician.

4. Brush teeth twice a day with a fluoride toothpaste. Brush first thing in the morning, before going to bed, and after each meal. Use a soft toothbrush, angel your brush towards gum line, use circular motions, change toothbrush every 3 months and try avoiding starchy and sugary snacks.

5. Drink water containing fluoride/ use a mouth rinse.

6. Ask dentist about anti-plaque or anti-gingivitis mouth rinse to control plaque.

7. Use dental floss to clean between teeth at-least once a day.

8. Another way of removing plaque between teeth is to use a dental pick/brush.

9. If wearing dentures, keep them clean and take them out at night.

10. Stay in constant touch with your dentist and visit him twice a year for checkups and cleaning. Follow his advices and let him know you have diabetes. Share results of the diabetes blood tests like A1C test or fasting blood glucose test. Ask for antibiotics before and after dental treatment if diabetes is uncontrolled.

Upon conclusion, we hope that you take care of your beautiful smile.

It is thus inevitable to keep the blood glucose at controlled levels to avoid worsening the conditions of gum diseases. But, when there is an infection, glucose levels will rise in response. If the problem in mouth becomes worse, there would be additional problems like those with food intake that might affect diabetes management. Therefore, always keep in touch with your dentist if you have diabetes blood sugar levels and dental treatment, heart problems.

High blood sugar levels may affect the time the gums take to heal. If you're on medication which might lead to hypos, like insulin or sulphonylureas, it is important to speak with the doctor to check if the medicines need to be modified.


Diabetes may lead to excess cholesterol building up in the bloodstream, thus raising the risk of heart diseases. Also, people with gum disease may have a higher risk since bacteria and inflammation in the gums may escape into the blood system and cause blockages in the vessels, reducing blood flow to the heart.

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