The Diabetes-Dental Health Connection
Simple tips to keep you smiling
Take a good look at your smile in the mirror. If you like what you see, you're probably doing a good job of managing your diabetes. On the other hand, if your oral health could stand some improvement, you may need to beef up your diabetes-management practices: Poorly controlled diabetes increases your risk of periodontitis (a severe form of gum disease), tooth decay and other oral health problems.
Diabetes can affect every aspect of your health—from the tips of your toes right up to your pearly whites. Here’s how to maintain a bright, healthy smile.
Making the connection
Diabetes lowers our ability to fight infection, making it harder for tissues to heal anywhere in the body—the mouth included. This is particularly true when blood glucose levels are not well controlled. Not surprisingly, persistently high blood glucose levels raise glucose levels in the saliva, thus, creating the perfect breeding ground for bacteria. In one study, scientists found that adults with Type 2 diabetes who had poor blood glucose control were much more likely to develop severe periodontitis than those without diabetes.
As with many diabetes complications, there are dental-disease risk factors you can change—such as smoking, diet and blood glucose control—and others you can’t change—such as your increasing age and how long you have had diabetes.
Practice daily prevention
Keeping tight control over your blood glucose levels is the most important preventive measure. However, it’s only the beginning.
When you have diabetes, every day you need to devote time to the fitness of your teeth. The American Diabetes Association (ADA) recommends these daily dental health tips:
- Brush twice daily, for a minimum of three minutes.
- Replace your toothbrush when the bristles are worn out, every three to four months.
- Brush the surface of your tongue to remove germs.
- Floss daily. Use a gentle back-and-forth motion, and avoid pressing the floss into gums.
- Rinse with water when done.
Be aware of the signs of gum disease
Know the possible signs and symptoms of gum disease and regularly check for them. Immediately schedule an appointment with your dentist if you notice any of these:
- Gums that bleed when you brush or floss
- Red, swollen or tender gums
- Gums that have pulled away from the teeth
- Bad breath
- Loose teeth
- Noticeable changes in how teeth fit together when you bite down
- Changes in how partial dentures or bridges fit
Partner with your dentist
Maintaining good blood glucose control and practicing good oral hygiene at home are great starts. However, because the early stages of gum disease are painless, only regular visits to a dentist can tell you for sure if your mouth is healthy. The American Diabetes Association recommends that you visit your dentist at least twice a year. The Centers for Disease Control and Prevention also recommends that people with diabetes see a dentist every six months—and more often if they have periodontal disease.
And don’t let the cost of a dental visit keep you from going. Regularly scheduled appointments with a dentist now can prevent many expensive trips and medications later. When talking to your dentist, try to provide a complete picture of your health by sharing the following information:
- Tell your dentist that you have diabetes.
- Share your A1C level, which is a measure of your blood glucose control over the past three months.
- Describe any symptoms or concerns about your oral health.
Watch out for these oral health problems
Besides periodontitis, which is an inflammation of the gums, these dental problems are more common in people with diabetes:
- Tooth decay
- Periodontal disease (gum disease)
- Salivary gland dysfunction (mouth may feel dry)
- Fungal infections
- Inflammatory skin disease (in the form of lesions or painful ulcers in the mouth)
- Infection and delayed healing
- Taste impairment (can influence food choices toward sweeter-tasting carbohydrate foods)
- Dry mouth (increases the risk of tooth decay and periodontal diseases)
Tips for protecting your teeth
Make dental health a part of your daily diabetes management. This means eating a healthy diet, keeping blood glucose levels under control, practicing daily oral hygiene and quitting smoking.
Know the signs and symptoms of gum disease. Report them immediately to your dentist.
See your dentist at least every six months. If you have periodontal disease, your dentist may recommend more frequent visits. Share information about the state of your diabetes at every visit.
Get dental coverage if you can. Many people opt out of dental insurance in an effort to save money in the short term. This can lead to you paying big bucks to fix damage that could have been prevented.
Updated: July 2007
