Oral Health and Diabetes

Diabetes is a metabolic disease leading to high levels of sugar in the body. It is one of the most commonly encountered chronic diseases identified by health care providers including dentists. What many people might not realize is that uncontrolled blood sugar levels can cause problems for oral health and poor oral health can make it harder for a diabetic person to control their blood sugar levels. There are many complications from diabetes for the mouth including: xerostomia or dry mouth, burning sensation in the mouth, impaired/delayed wound healing, increased incidence and severity of infections, secondary infection with candidiasis or yeast, parotid salivary gland enlargement, gingivitis and/or periodontitis (American Dental Association).

Of great importance to diabetic control is periodontal health. The periodontium includes the ligament surrounding each tooth root and the supporting structures of that system including the bone and gums. It is this system that is critical for maintaining the teeth in the bone and chewing healthy food. Brushing our teeth properly two times daily and flossing helps to remove the bacterial biofilm responsible for cavities and gingivitis. Uncontrolled blood sugar causes a rise of sugar in the saliva, in turn causing a significant increase in bacterial activity. The immune response to the bacteria creates inflammation and sore, bleeding gums.

For most of us, when something hurts, we stop touching it. When we cut back on our oral hygiene habits, the bacteria grow rapidly and further increase inflammation which damages the ligament, bones and gums around each tooth causing periodontal disease. At this point, our teeth hurt! We start eating softer foods higher in sugar and poorer in nutritional status. Making healthy choices becomes harder when our mouth hurts. With a poor diet, diabetes becomes harder to manage because of a preventable problem, periodontal disease.

But there is hope! When you have a professional cleaning, the bacterial biofilm and buildup is momentarily removed allowing your gums a chance to heal. Done routinely the cleaning reduces inflammation, the cause of harmful molecules that make controlling blood sugar also harder. The bi-directional relationship between diabetes and oral health is important to understand so that everyone can be empowered to take control and manage their blood sugar levels to the best of their ability, prolonging a healthier and happier life!

For more info visit:

• Patient education from JADA: Journal of the American Dental Association https://jada.ada.org/article/S0002-8177(16)30610-9/pdf

• Podcast from National Diabetes Education Program presented by the Center for Disease Control and Prevention: https://tools.cdc.gov/podcasts/media/pdf/Periodontal.pdf