Diabetes and Oral Health: The Oral-Systemic Connection

It is estimated that up to 27 million Americans have diabetes, but only two-thirds of these individuals are diagnosed. Studies have shown that diabetics are more susceptible to the development of oral infections and periodontal (gum) disease than those who do not have diabetes. This relationship causes great concern because serious gum disease may have the potential to affect blood sugar control and contribute to the progression of diabetes. That's why it is important for people with diabetes to visit a dentist on a regular basis and to keep the dentist up to date on the status of the overall health.


How are gum disease and diabetes related?
Because diabetes reduces the body's resistance to infection, the gums are at risk for gingivitis, a reversible form of gum disease usually caused by the presence of bacteria. These bacteria produce toxins that create a sticky film that accumulate on teeth, both above and below the gum line, leading to inflammation. If left untreated, gingivitis can progress to periodontitis, an irreversible destruction of the tissues that surround and support the teeth.   


What other problems are associated with diabetes?

Other oral problems associated with diabetes include thrush (candidiasis); an infection caused by a fungus that grows in the mouth; and dry mouth; which cause soreness, ulcers, infections, and cavities. To prevent problems with bacterial infections in the mouth, diabetics may be prescribed antibiotics, medicated mouth rinses, and more frequent dental cleanings by their dentist.


How can I stay healthy?
Brush your teeth with an antimicrobial toothpaste containing fluoride and rinse with antimicrobial mouth rinse at least two times a day. People with diabetes who receive good dental care and have good insulin control typically have a better chance of avoiding gum disease.

To improve their quality of life and their oral health, people with diabetes need to pay close attention to diet and exercise. People with diabetes should be sure that both their medical and dental care providers are aware of their medical history and periodontal status. To keep teeth and gums strong, those with diabetes should be aware of their blood sugar levels in addition to having their triglycerides and cholesterol levels checked on a regular basis.


What is the best time to receive dental care?
If your blood sugar is not under control, talk with both your dentist and physician about receiving elective dental care. Types of dental procedures and appointment length are dependent on the level of diabetic control. Also, schedule morning appointments because blood glucose levels tend to be more stable at this time of the day. If you have a scheduled appointment, eat and take your medications as directed.