Diabetes is a disease that can impact the whole body — eyes, kidneys, heart and other important systems and functions. Diabetes can also create a higher-than-normal risk of oral health problems.
Dr. Sally Cram, a practicing periodontist in Washington D.C. and spokesperson for the American Dental Association, says the dental complications associated with diabetes include bleeding/swollen gums, frequent abscesses, loose teeth, receding gums and bad breath — all signs of periodontal (gum) disease.
When mouth’s reach the stage of periodontitis, pockets begin to form in the teeth and gums. If periodontitis goes unchecked, the infection can work its way into the bone around the base of the teeth. In some cases, this may require gum surgery to correct the condition.
“If left untreated, and with blood sugar running high, you can eventually lose teeth,” Cram says.
Maintaining control of blood glucose levels is key to keeping additional health risks, like gum disease, at a minimum. It’s also important for a dentist to know a patient’s medical history as it relates to diabetes. Cram says while diabetes isn’t necessarily detected through dental exams, dental issues can lead dentists to suspect the disease.
“A review of the patient’s overall health and medical history, coupled with a dental periodontal exam, may lead us to suspect uncontrolled diabetes,” Cram says. “It’s especially important if the patient has a family history of diabetes, is overweight or has any of the symptoms of diabetes. It is so vitally important to talk to the patient as well as look at the oral clinical findings and get information that may lead us to suggest a good physical exam and testing for diabetes.”
Diabetics may be more prone to periodontal disease and oral fungal infections because of the impacts the disease has on the body’s immune system. Many diabetics suffer from dry mouth. When the oral tissues dry out, Cram says, that’s when fungi and bacteria proliferate. In healthy mouths, the protective enzymes in saliva help reduce those growths. Diabetes may also cause glucose levels in saliva to increase, making the risk for periodontal disease and thrush (fungal infection) that much greater.
Common mouth problems for diabetics
Problem: Dry mouth
What it is: lack of saliva
Symptoms: constant feeling of dry mouth, rough tongue, mouth pain, cracked lips. Impaired function (talking, swallowing, chewing)
Treatment: prescription medication, avoiding certain products (spicy, or salty foods, caffeine, tobacco, alcohol), using a humidifier, drinking more water
What it is: mild to severe gum disease
Symptoms: gums that pull away from teeth, infection, chronic bad breath, changes in bite, loose teeth, bleeding gums
Treatment: deep cleaning from dentist, prescription medication, gum surgery
What it is: fungus growth
Symptoms: sore white or red patches on the surfaces in the mouth that can turn into open sores
Treatment: prescription medication
What it is: unhealthy or inflamed gums
Symptoms: red, swollen and bleeding gums
Treatment: daily brushing, flossing, regular dental cleanings
What it is: a burning sensation caused by uncontrolled blood glucose levels
Symptoms: burning feeling, dry mouth, bitter taste
Treatment: gaining control of blood glucose levels
Source: National Institute of Diabetes and Digestive and Kidney Diseases
Researchers have linked insulin resistance to elevated levels of salivary cytokines, which are released in response to inflammation in the body. The immune system’s response to inflammation leads to fat cells being unable to respond well to insulin and sees the fat cells releasing fatty acids into the blood, leading to higher-than-normal levels of cholesterol.
The good news is that proper preventive care can help eliminate a lot of the risks associated with poor oral health. Brushing twice a day, flossing and regular dental checkups and cleanings provide quality care to last many people a lifetime.
“Most dental problems are totally preventable by the simple things mentioned above. If you are having trouble controlling your diabetes, you may want to have your teeth cleaned professionally more frequently — maybe every three or four months. And always tell your dentist about any changes in your health or diabetes,” Cram says.