Diabetes and Your Oral Health: Facts You Need to Know


Nearly 24 million Americans have diabetes, 6 million of whom have not yet been diagnosed. Another 57 million suffer from pre-diabetes, which often progresses to the full-blown disease, and many of these people are also unaware they have the condition.

Healthy teeth and gums are an essential part of your overall wellness, as gum disease increases your risk of multiple serious diseases, including diabetes.

When you have type 2 diabetes, your body either does not make enough insulin or your cells become resistant to it. This means that when you eat, sugar from your meals builds up in your bloodstream because there isn’t enough insulin to remove it and transfer it to your cells.

The resulting high blood sugar that often occurs in diabetics is associated with a range of health complications, some of which you may not expect. In fact, one of the most often overlooked health issue that occurs alongside diabetes is gum disease … and this can be a very serious issue for your overall health.

What Does Diabetes Have to do With Your Teeth?

Diabetes may seem completely separate from your oral health, but poorly controlled blood sugar increases your risk of gum problems.

Gum disease is actually often considered the “sixth complication” of diabetes because people with diabetes are significantly more likely to have periodontal disease, according to a study in the Journal of Periodontology.

Research shows that people with uncontrolled diabetes tend to have more harmful proteins in their gum tissue, which leads to harmful inflammation. Meanwhile, beneficial proteins are reduced, which hinders your body’s normal ability to heal from a gum infection.

As the Academy of General Dentistry states, “In patients with uncontrolled diabetes, where the body is more prone to infection, gum disease is more severe or harder to control.”

On top of gum disease, diabetes also increase the risk of other oral health complications, including:

  • Slower healing time after dental surgery
  • Fungal infections
  • Dry mouth
  • Cavities

Your Mouth May Have Diabetic Clues Related to Your Blood Sugar

Having trouble controlling blood sugar? Gum disease may be contributing to the problem and making it more difficult for you to keep your blood sugar levels in a healthy range.

What exactly is gum disease? It’s a chronic bacterial infection that impacts your gums and the bone surrounding your teeth. It’s caused by plaque on your teeth, which leads to gum inflammation.

In its mildest form, gum disease is called gingivitis. Often due to poor oral hygiene, gingivitis causes your gums to become red and swollen, and bleed easily. If left untreated, gingivitis may progress into periodontitis, in which plaque begins to grow below your gum line.

The bacteria and the toxins they produce lead to chronic inflammation that can destroy your gums and the bone supporting your teeth. This leads to teeth separating from your gums, forming infected pockets that can result in tooth loss and, as the disease progresses, heart disease, respiratory disease and diabetes.

Gum disease is actually incredibly common, affecting about 80 percent of adults at some point during their lifetime, but it is not always obvious — especially in the beginning stages when it’s most easily treated and reversed.

According to the American Academy of Periodontology (AAP), some warning signs include:

  • Red, swollen or tender gums or other pain in your mouth
  • Bleeding while brushing, flossing, or eating hard food
  • Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before
  • Loose or separating teeth
  • Pus between your gums and teeth
  • Sores in your mouth
  • Persistent bad breath
  • A change in the way your teeth fit together when you bite
  • A change in the fit of partial dentures

Remember, if you have diabetes, pre-diabetes or risk factors of diabetes (overweight, inactivity, family history, etc.), the signs above could also be making it more difficult for you to keep your blood sugar levels under control, potentially predisposing you to diabetes or diabetes complications.

Gum Disease Also Increases Heart Disease: An Especially Important Concern for Diabetics

Red, swollen gums or bleeding while brushing or flossing are warning signs that you may have gum disease.

Gum disease is a double-edged sword for diabetics because along with increasing problems with blood sugar control it also increases the risk of heart disease.

Heart disease is a well-established complication of diabetes even if you don’t have gum disease, as people with diabetes are twice as likely to have heart disease or stroke. However, if you have gum disease as well, your risk may be even higher.

People with gum disease are actually nearly twice as likely to have heart disease, according to AAP. Gingivitis, cavities and missing teeth are also associated with heart disease, and can predict heart disease risk as well as cholesterol levels.

In fact, when your gums become diseased, they release toxic bacteria into your bloodstream, which promote inflammation and negatively impact your heart and other organs. So if you have diabetes, it’s imperative that you keep your gums healthy to ward off potentially deadly heart complications.

How to Get Gum Disease — and Diabetes — Under Control

In its early stages, gingivitis can often be treated and reversed through proper dental cleanings and attention to oral hygiene. Even more advanced gum disease can often be treated with deep cleaning of your root surfaces below the gum line, known as scaling and root planning, provided proper oral hygiene practices are maintained. In severe cases, however, surgery will be required so your best bet is to avoid and prevent gum disease entirely in the first place.

Brushing and flossing are the basics to keep your teeth healthy. The American Dental Association (ADA) recommends brushing your teeth twice a day and flossing daily for best results. You should also visit your dentist regularly — at least once every 6 months — to have your teeth professionally cleaned and get an oral health check-up.

But one factor that cannot be overlooked in your quest for healthy gums is eating a healthy diet. This will support your oral hygiene routine, making your teeth and gums strong and healthy, while also lowering your risk of diabetes and diabetes complications.

Sugar and starches (bread, crackers, cereal) are particularly problematic for your gums when they’re left on your teeth after a snack of meal. Sugar feed bacteria in your mouth, while both starches and sugar produce acid in your mouth that can erode tooth enamel and lead to cavities. Anytime you eat a sugary, starchy food, you should brush your teeth afterward to remove the damaging substances from your mouth, however sugary and starchy foods are the same ones you’re better off avoiding if you have diabetes.

If you eat an unbalanced, highly processed or fast-food diet, it will be impossible for your immune system to function at its best, and studies show that people with weakened immune systems have a higher risk of gum disease, according to the Academy of General Dentistry.

A processed, fast-food diet will also increase your risk of developing diabetes, so you can help prevent both diabetes and gum disease in one fell swoop by focusing your meals on fresh, whole foods like lean protein (chicken, grass-fed beef, eggs) and vegetables while avoiding or eliminating sugars and refined carbs like white bread, pasta, rice and white potatoes.

As an aside, the other diabetes-fighting “weapon” that should be in your arsenal is regular daily exercise. When combined with a fresh, healthy diet, exercise can help you to eliminate blood sugar problems and prevent diabetes entirely.

Likewise, a healthy diet coupled with regular attention to your oral hygiene will also help keep your teeth and gums healthy. Together, this is a surefire plan to keep both gum disease and diabetes at bay.

As always, if you have concerns about gum disease or diabetes, be sure to make an appointment with your health care practitioner to get on the road to recovery starting today.


American Academy of Periodontology “Connection Between Gum Disease and Diabetes”

American Academy of Periodontology “Symptoms of Gum Disease”

Journal of Periodontology, Vol. 70, No. 11, Pages 1313-1321

American Diabetes Association Diabetes Statistics

WebMD.com “Diabetes & Oral Health: How to Protect Your Teeth”

MayoClinic.com Diabetes Complications

Academy of General Dentistry