Oral health is one of many aspects of your wellbeing that can be impacted by diabetes, most notably through an increased likelihood of developing gum disease, tooth decay and other mouth problems. The link between diabetes and gum disease is explained by changes to your saliva, and it means it is absolutely vital that people with diabetes make an active effort to protect their oral health through tooth brushing and regular dentist checkups.
What is the connection between diabetes and gum disease?
One of the things that protects your teeth and gums from harm is saliva, but saliva production is reduced in people with diabetes. This can be a side effect of some diabetes medications as well as a symptom of the diabetes itself.
You may also find that, just as you have high levels of glucose in your blood, your saliva also has excess amounts of glucose. Lack of saliva and high levels of glucose in the mouth create favourable conditions for the build up of plaque and bacteria.
People with high blood sugar due to diabetes often struggle with their immune responses, the way the body reacts to fight harmful bacteria and other infections.
When there is an excess of plaque, this may lead to chronic inflammation in the mouth. Infection and inflammation of the gums are some of the main characteristics of gum disease. In reverse, inflammation from gum disease can increase blood sugar levels and is a risk factor for the development of diabetes in the first place.
Symptoms of diabetic gum disease
Early gum disease, including diabetic gum disease, can be quite difficult to detect. It is not usually painful, though you may experience some gum tenderness, toothache or pain when chewing as the disease progresses. Common symptoms include redness, receding or bleeding gums, increased sensitivity to hot or cold food and drink, widening gaps between your teeth or even loosening teeth. Bad breath can also be a sign.
Gum disease progresses through different stages. Early gum disease, when the inflammation is impacting the gum only, is known as gingivitis. If it is allowed to continue without proper treatment, it can develop into periodontitis. This is when gum disease reaches the bone beneath your gums. Whilst gingivitis can generally be reversed, the damage from periodontitis is usually permanent and can even lead to tooth loss.
How to improve your diabetes oral health
Everyone should practice good oral hygiene, but the connection between diabetes and gum disease means this is even more important for those with the condition. The easiest way to prevent the early buildup of plaque is thorough tooth brushing and use of interdental brushes at least twice a day. You should also swill your mouth out with water or mouthwash after eating acidic or sugary foods, something of particular concern to those who use sweets or fizzy drinks to treat low blood sugar.
Do not wear dentures whilst asleep. Products are available to help with dry mouth. You should schedule regular checkups with your dentist – they will tell you how frequently – but also contact them immediately if you notice any gum disease symptoms.
Other than good oral hygiene, you can also reduce your risk of developing gum disease by managing your diabetes effectively through both medication and lifestyle. A balanced diet, regular exercise, minimal alcohol consumption and no smoking are beneficial both for diabetes management and for your health more generally. Regulating your blood sugar levels remains key, and your diabetes healthcare team should be able to offer further advice.
Is gum disease the only oral symptom of diabetes?
There are a range of potential issues associated with poor diabetes oral health. Whilst gum disease is the most common, tooth decay, dry mouth/xerostomia, oral thrush, abscesses and tooth loss are all risks. Like gum disease, these may be linked to low saliva levels or excess amounts of glucose in the saliva, which in turn lead to the growth of bacteria. These bacteria often produce acid, which erodes the enamel of your teeth and contributes to decay.
The key to minimising the likelihood that you will develop diabetic gum disease or other problems with your teeth and gums is to be aware of the risk, be diligent in your oral hygiene, and ensure you attend regular dental appointments. This is alongside more general diabetes management such as keeping your blood sugar low and trying to maintain a healthy lifestyle.
FAQs
What is the relationship between diabetic gum disease and saliva?
People with diabetes produce less saliva, and the saliva that they do produce is higher in sugar, just like their blood. Saliva plays a vital role in protecting your teeth and the rest of your mouth, so this helps explain why diabetes oral health can be poor. As gum disease is another contributor to high blood sugar levels, this can also work in reverse, with preexisting gum disease increasing your diabetes risk.
Are gum disease and periodontitis the same thing?
Periodontitis is a form of gum disease. Specifically, it is an advanced progression of gum disease that does not just impact the tooth and gum, but also the bone beneath them. By this point, the damage cannot be undone and there is a significant risk that you will lose the tooth. Gingivitis is the earlier, and reversible, form of the condition.
Is gum disease the only way that diabetes impacts oral health?
No. High levels of glucose in your saliva can encourage the accumulation of acid-producing bacteria that can contribute to tooth decay. People with diabetes are also at higher risk of infections such as oral thrush. Infections can, in turn, lead to the development of abscesses. Other possible problems include xerostomia, or dry mouth, or irritation or soreness more generally. This is why it is so important to practice good oral hygiene and visit the dentist regularly.
