The Link Between Diabetes and Gum Disease

Taking care of teeth and gums is especially important for people with diabetes. High blood sugar increases the risk of periodontal disease, an infection of the gums and bone that holds teeth in place.

Nurse practitioner Natalie Bellini, CNP, of University Hospitals Diabetes and Metabolic Care Center shares more.

How Diabetes Affects Oral Health

“Periodontitis, also called gum disease, is a serious gum infection that damages the soft tissue around teeth. Periodontal disease can be painful, cause bad breath and chewing difficulties,” says Bellini.

Bellini details the unique oral health risks that people with diabetes face:

• Saliva changes. High blood sugar changes the saliva in the mouth, including increasing glucose in the saliva. These changes can promote the growth of harmful bacteria, plaque and tooth decay.
• Dry mouth. High blood sugar can also cause dry mouth, which can lead to soreness, decay and a fungal infection called thrush. Some diabetes medications can also reduce saliva production, increasing dry mouth issues.
• Slow healing. Diabetes slows down healing, which can make treating gum disease more challenging. Infection and poor diet can make blood sugar even more difficult to control.

“When you have chewing difficulties and lose teeth or have pain, you end up with poorer nutrition because things that are easy to chew tend to be soft foods, processed foods, not broccoli and apples,” says Bellini. “People with pain often stop eating fiber and other nutrients needed for proper nutrition.”

Oral Health and Heart Disease

Gum disease increases the risk of cardiovascular disease and other health issues. Studies have shown a strong link between gum disease and cardiovascular disease. It’s believed bacteria and inflammation in the mouth can damage blood vessels elsewhere in the body.

“A big concern is that with periodontal disease, you have a two to three times higher risk of having heart attack, stroke or other heart issues,” Bellini says. “And the challenge is people with diabetes already have an increased risk of cardiovascular disease.”

Signs of Tooth and Gum Disease

• Tooth pain
• Sensitivity to hot and cold
• Bad breath
• Swollen gums
• Frequent bleeding gums

How to Keep Your Mouth Healthy

“We want people with diabetes at bare minimum to go to the dentist every six months for thorough teeth cleaning and assessment,” Bellini says. “Some of our patients with diabetes as they age or if they have high blood sugar levels, are seen every three months or even more often.”

Bellini shares a few additional tips for maintaining oral health:

• Keep blood sugar under control.
• Practice good oral hygiene. Brush and floss twice daily.
• Quit smoking, which increases risk of gum disease and other diabetes complications.
• Eat more natural foods. Fruits and vegetables are important for bone and dental health and help manage blood sugar levels.
• Drink fluoridated water (tap water).

Your dentist will suggest how often you should be seen based on your health. “If you don’t know how to floss correctly, if you’re struggling with bleeding gums, don’t stop brushing and flossing,” says Bellini. “Go to your dentist and they will help you learn to do it correctly.” If you’re anxious about visiting the dentist because of pain or other issues, ask about mild sedation.

Related Links

Led by an experienced team of clinicians and researchers, the University Hospitals Diabetes & Obesity Center provides ongoing care, management and education for diabetes, prediabetes, obesity and related conditions.