Dental problems and diabetes often go hand in hand. Diabetes can lead to oral health problems due to high blood sugar levels. In turn, oral health problems like infections can lead to diabetes by affecting insulin resistance. 

High blood glucose levels in saliva provide an environment for bacteria to grow and lead to a higher amount of plaque, and gum disease can affect the body’s ability to regulate blood glucose levels. This is why it’s so important to take care of your teeth, pay close attention to any changes in your mouth, and get treatment for problems as soon as possible.  

Oral health risks with diabetes

Here are the main oral health problems that are more likely with diabetes: 

• Tooth decay. High blood sugar levels over time can cause cavities due to a buildup of plaque.  
• Gingivitis. Gingivitis is the first stage of gum disease in which the gums become red and swollen. 
• Gum Disease. Also called periodontitis or periodontal disease, this occurs when gingivitis goes untreated. Symptoms include:
  • Bleeding gums
  • Changes in the spacing of your teeth
  • Bad breath that won’t go away
  • Receding gums
  • Loose teeth
  • Ill-fitting dentures
  • Red, swollen gums
• Thrush. Thrush is a fungal infection caused by yeast. You may notice sore patches on your gums or the roof of your mouth.  
• Dry mouth. Dry mouth can be a symptom of diabetes medications, including those for diabetic neuropathy. An oral rinse, sugar-free hard candy, or using a humidifier might help increase saliva. 
• Oral burning. Occasionally high blood sugar can lead to a burning sensation and bitter taste in your mouth. You may need to adjust your diabetes medications. 

These risks increase the longer you’ve had diabetes, the higher your fasting blood glucose, and the higher your A1C.

What you can do

The main thing is to maintain healthy blood glucose levels and refrain from smoking. 

Other things you can do to maintain good oral health are brushing and flossing every day, and visiting the dentist twice a year. Don’t give up on flossing if it causes bleeding at first; your gums will soon toughen up and bleeding should cease.

If you have periodontal disease, your doctor may recommend an antibiotic rinse. There is also a procedure called scaling and root planning, in which your dentist performs an intense cleaning of the gums. In rare cases, gum surgery might be necessary. 

Your dentist visit

When you visit the dentist, make sure to remind him or her that you have diabetes and what medications you are on, especially if you take medication for a heart condition. Check your teeth, gums, jaw, tongue, roof of your mouth, and insides of your cheeks often to see if anything looks off, including dry patches or bleeding.

Do not visit the dentist if your blood sugar levels aren’t under control, as this puts you at risk for infection. If you must visit the dentist, you may need to take antibiotics before and after your visit. 

Be sure to follow your dentist’s advice for how to take care of oral health problems. If the idea of going to the dentist makes your nervous, talk to your dentist about making adaptations to help you feel more at ease.