Diabetes & Oral Health
Table of Contents
- How Diabetes Affects the Mouth
- Why Are Mouth Problems More Common with Diabetes
- Oral Symptoms of Untreated Diabetes
- What Happens If I Have Plaque?
- Most Common Mouth Problems from Diabetes
- Signs & Symptoms
- Prevention
- Tips for a Healthy Mouth with Diabetes
- References
Diabetes can cause a host of health problems, including mouth and dental health issues.
Diabetes results in too much sugar (glucose) in your blood. When you have too much in your blood, you also have too much sugar in your saliva and mouth.
White blood cells, which are important for fighting off infections, are weakened due to high blood sugar. Diabetes also increases your risk for gum disease and dry mouth.
Practicing good oral hygiene and eating a balanced, nutritious, and low-sugar diet can minimize your risk for diabetes and oral health concerns. If you recognize the early signs of diabetes, you can form a plan for keeping the disease under control and improving your oral and overall health.
How diabetes affects the mouth
People with diabetes are more likely to also have gingivitis (early-stage gum disease) and periodontitis (advanced gum disease), the American Diabetes Association warns. Close to 60 percent of people with periodontal disease also have diabetes, compared to the less than 38 percent of the general public that has periodontal disease but not diabetes.
Diabetes leads to an increased amount of sugar in the bloodstream, and therefore the saliva, which can raise the odds for tooth decay and cavities. A study on type II diabetic patients shows rates of dental caries (cavities) in nearly three-quarters of the diabetic group and in only a third of the control group. Diabetic patients therefore had dental caries at rates more than double people without diabetes.
Dry mouth is also common in people with diabetes. Xerostomia, or dry mouth, is found between 12.5 percent and 53.5 percent of the time in people with diabetes, and it is found up to 30 percent of the time in the population without diabetes.
Dry mouth can cause a myriad of dental issues, including a higher incidence of tooth decay and gum disease, bad breath, more pain, mouth ulcers, and infections as well as a higher rate of fungal infections, such as thrush.
Why are mouth problems more common in people with diabetes?
Diabetes occurs when your body cannot regulate the amount of sugar in your blood, which can cause a variety of health problems. When too much sugar builds up in your mouth, the naturally present bacteria can increase and form plaque, the sticky substance that forms on the teeth.
Nearly everyone can develop plaque regardless of whether or not they have diabetes, but sugar is a known culprit for increasing plaque buildup on the teeth. When plaque is left on the teeth, this is what causes tooth decay, gum disease, and holes in the teeth, or cavities.
Other oral health issues related to diabetes are a higher rate of inflammation and more difficulties fighting off infections. The higher your blood sugar, the weaker your white blood cells, which are vital for fighting infections, the CDC explains.
This can mean it takes mouth infections longer to heal. It also raises the risk for developing infections in the first place.
Inflammation of gum tissue can cause pain, redness, and bleeding. It can also develop into gingivitis and then periodontal disease without prompt treatment.
Dry mouth can be a side effect of diabetes directly or related to medications. Either way, chronic dry mouth can create oral health issues, as less salivary flow means that bacteria and food particles are not as easily washed away. This can create a higher risk for tooth decay, gum disease, bad breath, mouth sores, and infections.
Oral symptoms of untreated diabetes
Diabetes can often be spotted by dental professionals due to oral health concerns. If you notice changes in your teeth, mouth, or gums, talk to your dentist, as it could be a sign of a bigger, underlying medical condition such as diabetes.
Type II diabetes develops most commonly in adults over the age of 45 when the body does not create enough insulin to control blood sugar.
Oral symptoms of diabetes can include the following:
Irritated and swollen gums
Gums that bleed easily when you brush and floss
Dry mouth
Mouth sores and infections
Wounds that take longer to heal
White patches in the mouth
Bad taste and/or bad breath
Difficulties tasting food
Higher rate of cavities
The American Dental Association (ADA) reports that in children with untreated diabetes, teeth can erupt (come in) earlier than usual.
What happens if I have plaque?
Plaque is common. A good oral hygiene routine can help to keep it from hardening and remaining on your teeth.
Plaque is a sticky substance created from the interaction between naturally occurring bacteria in your mouth and the acids in foods. A high-sugar diet can increase the production of plaque.
The same is therefore true for high blood sugar. Even if your diet is not necessarily high in refined sugar, your body cannot control the level of sugar in your blood when you have diabetes, which can cause plaque to form at faster rates. Brushing and flossing your teeth can help to remove plaque before it hardens.
When left on your teeth, plaque buildup hardens. At this point, it can only be removed by a dental professional through a professional cleaning. If it’s not removed, plaque eats away at the outer layer of your teeth (the enamel) and can irritate your gums.
Irritated gums can cause inflammation and early-stage gum disease. Essentially, plaque on your teeth destroys the enamel, causing tooth decay and then eating holes in the teeth called cavities.
Most common mouth problems from diabetes
These are the most common dental issues related to diabetes:
This is the early stage of gum disease. It involves inflammation and infection of the tissues that support your teeth, including the gums and jawbone. Symptoms of gingivitis include the following:
Tender gums when touched
Gums that bleed when brushing or flossing
Swollen gums
Mouth sores
Bad breath
Gums that look shiny
Gingivitis is treated with a thorough professional teeth cleaning at your dentist. The dental professional can remove the plaque from your teeth and just under your gum line to sooth the irritation and remove the infection.
Early gum disease is treated through proper hygiene techniques that includes twice-daily toothbrushing and daily flossing after the professional cleaning.
This is a more advanced stage of gum disease that generally occurs when gingivitis progresses after plaque remains on the teeth. It is a serious infection that damages the soft tissues and gums.
It can also migrate to the bones supporting the teeth. Pockets of infection can form between the teeth and the bones where bacteria can build up. It can range in severity with the most significant progression leading to bone and tooth loss.
Symptoms include the signs of early gum disease as well as the following:
Gums recession or gums that pull away from the teeth
Pain in the gums and teeth
Gums that bleed easily
Teeth feeling loose
Bad breath, foul taste, and pain while chewing that becomes significant
Tooth loss (in advanced stages)
Inflammatory response throughout the body
Treatment for periodontitis depends on the severity of the disease progression, but it will be aimed at removing the infection. Often, a more advanced deep cleaning, such as a root scaling and planing, will be necessary to scrape the infection out.
Your dentist may also prescribe antibiotics to fend off infection. Surgical treatments can be necessary if periodontitis persists and is significantly advanced.
When bacterial buildup creates plaque that damages your tooth’s enamel, this is tooth decay. This causes the minerals to be lost. Early stages of tooth decay can create a white spot on your tooth.
Symptoms of tooth decay can include the following:
Tooth pain
White or brown stains on the tooth
Tooth sensitivity to hot and cold
Abscess formation
Tooth decay can be reversed in the early stages through proper oral hygiene and professional dental cleanings. Once more minerals are lost and enamel is destroyed, it cannot be replaced.
A cavity is a hole in your tooth caused by tooth decay and the destruction of the enamel. Symptoms of a cavity are similar to tooth decay, but they can also include a hole appearing in your tooth.
Treatments for cavities include the following:
Professional fluoride treatment
Dental fillings
Root canals
Crowns
Tooth extraction (in severe cases)
Dry mouth occurs when there is not enough saliva in your mouth. This can be uncomfortable. It can also cause more bacterial buildup and therefore an increased rate of infections.
These are symptoms of dry mouth, or xerostomia:
Dry or sticky feeling in the mouth
Rough and dry tongue
Cracked or chapped lips
Burning sensation in mouth
Difficulties chewing, swallowing, tasting food, and talking
Throat feeling dry
Mouth sores
Infections in the mouth
Dry mouth treatment can include chewing sugar-free gum and drinking small sips of water throughout the day, as well as avoiding caffeine, alcohol, and tobacco products. More significant dry mouth can be treated with medications, over-the-counter or prescription mouthwashes, and artificial saliva or moisturizers.
Mouth sores and infections can include viral and bacterial infections that can be caused by dry mouth or a lowered immune system, both related to diabetes. Symptoms can include the following:
Pain
Open wound
White patches
Blisters
Inflammation
Treatment for the infection will depend on the type of infection, the direct cause, and its severity. Mouth sores and infections can be treated with topical treatments and medications when needed.
Signs & symptoms that mouth problems are due to diabetes
Many of the oral issues that can be related to diabetes are also common in general, so it can be tricky to know that diabetes is the cause. Watch for early stages of gum disease and tooth decay as well as an increased rate of mouth infections and wounds that seem to take longer to heal than they should.
If you notice dry mouth, gum irritation, bad breath, or any changes in your dental health, talk to your dentist. A blood test can help to determine if you have diabetes.
Prevention with proper dental care
Preventing oral health issues and diabetes often starts with diet and nutrition. Eating a balanced and healthy diet that is low in processed foods and refined sugars can help.
Consider these other nutritional tips:
Eat a variety of foods from all the food groups.
Stick to raw and natural foods when possible.
Include foods that are high in calcium, vitamin C, and phosphorus to support bone, teeth, and gum health.
Drink plenty of water.
Limit caffeine and alcohol.
Try to minimize snacks between meals.
Regular exercise, along with a balanced diet, can also help to keep you healthy and limit the risk for diabetes and climbing blood sugar levels.
It is also important to stick to a healthy oral hygiene routine that includes the following:
Brush your teeth for two minutes at least two times per day.
Floss your teeth daily.
Use a fluoride toothpaste.
Get regular dental examinations and professional cleanings.
Consider a daily fluoride mouthwash.
Tips for a healthy mouth with diabetes
When you have diabetes, you will need to pay extra attention to your mouth and take some additional steps beyond regular dental hygiene to keep it healthy.
Keep your glucose levels under control. Exercise regularly, eat a healthy diet, and take medications when needed. Lower blood sugar levels can minimize the risk for infections and other oral health concerns.
Do not smoke. Smoking increases the rate and progression of gum disease. It can also make diabetes worse.
If you wear dentures, be sure to clean them properly every day. Talk to your dentist if the fit seems off.
Maintain your oral hygiene by brushing and flossing daily. See your dentist as recommended, generally two times per year on average.
Let your dentist know you have diabetes. Talk to them about your health and any potential changes, pain, inflammation, or irritation in the mouth.
Diabetes is a disease that can be successfully managed with medical help. It is essential to keep up with your oral hygiene and monitor your gums, teeth, and mouth when you have diabetes.
Your dentist can help you to develop and carry out a plan for keeping your overall and oral health under control along with your diabetes.