Diabetes, Gum Disease, & Other Dental Problems


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Diabetes can affect many parts of the body, including the mouth. People with diabetes are more likely to suffer from gum disease, tooth decay, and other tooth and gum problems.1 Some of these oral problems may make your diabetes worse.

Taking good care of your teeth and gums, including regular cleanings and necessary treatments, will help you prevent these problems or stop them from getting worse. Maintaining a healthy mouth also makes it easier to manage diabetes and prevent diabetes-related health problems, such as heart disease and kidney disease.1

A person inserts a dental tool into the open mouth to clean teeth.Good dental care can prevent oral problems and help you manage diabetes.

How does diabetes affect my mouth?

Diabetes affects your mouth by changing saliva, the fluid that keeps your mouth moist. Saliva helps prevent cavities by flushing away food particles, preventing bacterial growth, and fighting the acids produced by bacteria. Saliva also contains minerals that help protect oral tissues and fight cavities.

Diabetes and some medications used to treat diabetes can cause the salivary glands in the mouth to produce less saliva. When saliva flow is reduced, the risk of tooth decay, gum disease, and other oral problems increases.

Diabetes also increases the amount of glucose in saliva. Diabetes occurs when your blood sugar levels, also called blood sugar, are too high. High glucose levels in the blood can also cause glucose to build up in the saliva. This glucose can feed harmful bacteria, which combine with food to form a soft, sticky film called plaque, leading to tooth decay. If not removed, plaque can also accumulate on teeth near the gum line and harden into deposits called tartar, leading to gum disease.

If left untreated, these oral problems can lead to tooth loss. Nearly 25% of U.S. adults age 50 and older with diabetes have significant tooth loss, compared with about 16% of people without diabetes.2

What are the most common oral problems with diabetes?

gum disease

Gum disease, also known as periodontal gum disease, is the most common and serious oral problem associated with diabetes. If left untreated, the disease progresses in stages, from gum inflammation to tooth loss. High blood sugar increases the risk of gum disease progressing from mild to severe.1

Close-up illustration of teeth and gums showing the four stages of gum disease: (1) healthy gums and teeth, (2) gingivitis, (3) periodontitis, (4) advanced periodontitis. The label notes inflammation, calculus, periodontal pockets, bone destruction, advanced bone loss and deep pockets.Gum disease progresses in stages, from gum inflammation to tooth loss.

Gingivitis or inflammation of the gums

The first stage of gum disease is gingivitis, a mild inflammation of the soft tissue surrounding the teeth. Gingivitis occurs when plaque and tartar build up on the teeth near the gum line, irritating and inflaming the gums. As a result, your gums may become red, swollen, and may bleed easily.

periodontitis

If left untreated, gingivitis can progress to periodontitis, an infection of the gums and bone that holds the teeth in place. Your gums may pull away from your teeth, forming pockets that slowly become infected. Bacteria in the mouth and the body's response to the infection begin to break down the bone and tissue that hold the teeth in place. If periodontitis is not treated, the teeth may become loose and may even need to be extracted.

Other common oral problems

In addition to gum disease, diabetes increases the risk of:3

  • Tooth decay
  • Dry mouth and lack of saliva, which may lead to sores, sores and infections
  • Oral thrush, a fungal infection that causes painful white patches in the mouth
  • Burning mouth syndrome, a burning sensation in the mouth caused by uncontrolled blood sugar levels
  • Changes in the taste of food and drinks

These oral problems, along with tooth loss, can make it more difficult to follow a healthy eating plan that helps manage diabetes.

How do I know if I have oral problems due to diabetes?

Check your mouth for signs and symptoms of diabetes problems, such as1

  • Gums are
    • redness, swelling, or bleeding
    • Back
    • stay away from your teeth
  • loose teeth
  • Increase the space between teeth
  • Dry mouth, an important symptom of diabetes
  • Bad breath does not go away after brushing teeth

A woman checks her teeth in the mirror.Check your mouth for signs of diabetes problems.

What should I do if I have oral problems due to diabetes?

If you notice any signs or symptoms of oral problems, see your dentist immediately. Your dentist is an important ally in maintaining oral health and treating oral problems before they become serious.

if you have diabetes

  • Tell your dentist about your diabetes, including how long you have had it, any diabetes-related problems you may have, and any medications you take
  • Let your dentist know about any changes in your health, including any increases in blood sugar levels
  • Ask how often you should have regular cleanings and inspections
  • Follow your dentist’s advice on how to prevent and treat oral problems caused by diabetes

If you are nervous about going to the dentist, tell your dentist and staff how you feel. Your dentist can tailor your treatment to your needs.

Dental professional uses dental tools to examine the mouth and teeth of an elderly patient.If you notice any oral problems, see your dentist immediately.

How do I prepare for dental work?

High blood sugar increases the risk of infection after oral surgery and can also cause your mouth to take longer to heal. If you are having oral surgery or other extensive dental treatment, tell your doctor.To help you prepare for surgery and recover after surgery, talk to your doctor

  • How often should you check your blood sugar before and after surgery?
  • What changes, if any, should you make to your medication, such as changing the dose or timing of taking it?
  • How to best treat pain after surgery

How can I keep my mouth healthy?

Keep your mouth healthy (PDF, 242.78 KB) by taking these steps

  • Keep your blood sugar within your target range. Your doctor can help you set goals and explain what to do if your numbers are too high or too low.
  • Eat healthy meals and drinks and follow the eating plan developed by you and your doctor or registered dietitian.
  • Visit your dentist regularly. Ask your dentist how to care for your teeth at home, including the cleaning tools and products you should use. Your dentist can recommend a cleaning procedure that suits your needs.

Taking good care of your teeth isn't always easy. Challenges may include finding a dentist near you who can help you develop a dental routine that works for you and who is affordable for dental care and related products.If you're concerned about cost, consider free or low-cost dental care options such as

  • Community health centers across the country offer free or reduced-price health services, including dental care.
  • Medicaid is a state-run program that provides medical benefits to eligible individuals and families. Most states provide limited dental services for adults, while some provide comprehensive services.

Don't let these concerns stop you from getting regular checkups. Waiting too long to take care of your mouth may make the situation worse.

Smoking increases the risk of many diabetes and oral problems. If you smoke or use other tobacco products, please stop. Get help so you don't have to do it alone. You can start by calling the National Tobacco Tobacco Hotline at 1-800-QUITNOW or 1-800-784-8669. For tips on quitting smoking, visit Smokefree.gov.

Clinical Trials for Diabetes and Gum Disease

NIDDK conducts and supports clinical trials for many diseases and conditions, including diabetes. These trials are designed to find new ways to prevent, detect or treat disease and improve quality of life.

What clinical trials are available for diabetes and gum disease?

Clinical trials and other types of clinical research are part of medical research and involve people like you. When you volunteer for clinical research, you help doctors and researchers learn more about disease and improve people's health care in the future.

Researchers are studying many aspects of diabetes and gum disease, such as how certain genes play a role in diabetes, gum disease, heart disease and bone loss.

Find out if clinical research is right for you.

Watch a video of NIDDK Director Griffin P. Rodgers, Ph.D., explaining the importance of participating in clinical trials.

What clinical studies in diabetes and gum disease are looking for participants?

You can find clinical studies on diabetes and gum disease at www.ClinicalTrials.gov. In addition to searching for federally funded studies, you can expand or narrow your search to include clinical studies from industry, universities, and individuals; however, the NIH does not review these studies and cannot ensure their safety sex. Always talk to your health care provider before participating in a clinical study.

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