Diabetes is a disease that can affect the whole body — including the mouth. People with diabetes face a higher than normal risk of oral health problems.
The link between diabetes and oral health problems is high blood sugar. If blood sugar isn’t well managed, oral health problems are more likely to develop. This is because unmanaged diabetes weakens white blood cells, which are the body’s main defense against bacterial infections that can occur in the mouth.
Just as studies have shown that regulating blood sugar levels lowers the risk of major organ complications of diabetes — such as eye, heart, and nerve damage — so to can diabetes protect against the development of oral health problems.
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People with diabetes who smoke are at an even higher risk — up to 20 times more likely than non-smokers to develop thrush and periodontal disease. Smoking also seems to impair blood flow to the gums, which might affect wound healing in this tissue area.
Since people with diabetes are more prone to conditions that might harm their oral health, it’s vital to follow good oral hygiene practices, pay special attention to any changes in your oral health, and to call your dentist immediately if such changes occur. Suggestions to prevent or reduce oral health problems include:
There are two schools of thought on this topic. One school believes that high glucose levels in the saliva of people with unmanaged diabetes helps bacteria thrive. This leads to the development of caries (tooth decay or cavities) and gum disease. Also, people with diabetes tend to eat smaller, more frequent meals throughout the day. This increases the chance for bacteria to grow and cavities to develop.
The other school believes that people with diabetes know more about what to eat and the need to closely monitor their sugar intake. They don't eat many foods containing cavity-causing sugar.
The fact is that people whose diabetes is well-managed have no more tooth decay or periodontal disease than people without diabetes. Good oral hygiene and good blood sugar regulation are the best protections against cavity formation and periodontal disease.
Many factors play a role in the loss of teeth in people with diabetes. First, people with unmanaged diabetes are more prone to the development of gingivitis and periodontal disease. If the infection persists, it can spread to the underlying bone that anchors the teeth. Complicating this situation is the fact that infections don’t resolve as quickly in people with diabetes.
The good news for people with diabetes is that by practicing good oral hygiene habits — brushing at least twice daily (or preferably after every meal) with a toothpaste that contains fluoride, flossing daily and keeping blood sugar levels well managed — the potential for infection from periodontal disease will be greatly reduced or eliminated, and so will the risk of tooth loss.
With close medical care and self-care that keeps blood sugar as close to normal as possible, and good personal and professional dental care, problems after surgery are no more likely in people with diabetes than in those without the disease.
Last reviewed by a Cleveland Clinic medical professional on 08/29/2019.
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