Are There Dental Problems Associated With Diabetes?

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Diabetes is a chronic condition characterised by high levels of glucose in the blood. Having diabetes can make it more difficult to have good oral health. People with diabetes are more likely to develop oral infections and suffer from gum disease. It also takes longer for diabetics to heal from dental procedures.


How Does Diabetes Affect The Mouth?

Diabetes can affect the oral cavity in many ways. High sugar levels are present not only in the blood, but the saliva as well. Oral bacteria process sugar to help them multiply and this can lead to the formation of plaque. 

Plaque sticks to your teeth and produces acids which can erode the protective layer of your teeth, known as enamel. By extension, this can promote dental cavities and gum disease. 

Dry mouth is also a common symptom of diabetes. People suffering from diabetes often feel thirsty. This may also be caused as a side effect of taking diabetic medications, such as metformin.

Another way diabetes affects the mouth is by causing blood vessels to thicken. This reduces blood flow, which can deprive teeth and oral tissues of nutrients, causing them to become weak.

High blood sugar levels can weaken the response of white blood cells to infections, prolonging the period it will take for a diabetic person to heal from oral infections and dental operations. 


How Can A Dentist Tell If You Have Diabetes?

While a dentist won’t treat you for diabetes, they can pick up on early signs of diabetes, based on your oral health. If you present with frequent oral infections like thrush, progressive gum disease, dry mouth, burning tongue or dental cavities, your dentist can suspect diabetes or pre-diabetes. 

If these oral conditions are accompanied by other symptoms such as weight loss, fatigue or frequent urination, your dentist may refer you to a general practitioner for further testing and evaluation.


What Dental Problems Can Diabetes Cause?

1. Gingivitis

Gingivitis is the inflammation of the gums. Diabetes causes increased glucose content in the saliva of the mouth. This promotes the growth of bacteria and the development of plaque. Plaque can solidify on teeth into what is known as tartar. 

Due to the presence of plaque and tartar, the gums can become inflamed or infected. This presents as red, swollen and tender gums which can bleed easily when brushed. The gum line may also be drawn back from the teeth. 

Left untreated, gingivitis can be the first stage of a more serious oral condition called periodontal disease.

2. Periodontal Disease

Having uncontrolled blood sugar levels can easily cause gingivitis to progress to gum disease. The teeth and gums become infected and the gums recede, causing pockets of bacteria to form below the gumline. 

The disease can progress to a point where the roots of the teeth become exposed, leading to tooth loss. In severe cases, the jaw bone can become infected and the infection can enter the bloodstream and affect other parts of the body.

3. Dry Mouth

Diabetic people often find themselves feeling thirsty. When there are high levels of glucose in the blood, the kidneys draw in water to excrete glucose from the body through urination. This causes dehydration. 

While the mechanism is not entirely clear, diabetes can also reduce the production of saliva from salivary glands, thereby causing dry mouth. When a person has a dry mouth they can feel a sticky sensation and have difficulty eating, swallowing or speaking.

Saliva plays an important role in protecting teeth as it washes away bacteria and neutralises acids which can damage tooth enamel. Therefore, dry mouth places diabetics at risk of tooth decay.

4. Oral Infections

Dry mouth and high blood sugar levels are characteristic of diabetes, both of which can cause yeast to multiply in the mouth. This causes the development of oral candidiasis, also known as oral thrush. 

Oral thrush presents as white patches on the tongue, inner cheeks or roof of the mouth. A person may experience pain, loss of taste and redness or bleeding in the affected areas.

Burning mouth syndrome is another oral condition attributed to diabetes. It causes a burning, dry and stinging feeling anywhere inside the mouth. Getting blood sugar levels under control is thought to provide symptomatic relief.

5. Impaired Wound Healing

As explained earlier, diabetes can impair wound healing by reducing blood flow to tissues and weakening the immune system of an individual. When there aren’t enough nutrients or white blood cells being sent to affected tissues, healing can be delayed. The extent of the delay is related to the severity of the diabetes.


How Can Diabetics Maintain Good Oral Health?

If you’re diabetic, you should do the following:

  • Regularly check your blood sugar levels at home using a glucometer. This will give you a good indication of how controlled your diabetes is day to day.
  • Take your medication on time, as prescribed by your doctor.
  • Schedule regular consultations with your doctor to assess how well your diabetes is being controlled.
  • Maintain good oral hygiene by brushing your teeth twice a day and flossing at least once a day. 
  • Inform your dentist you have diabetes. This can help inform decision-making for dental procedures.
  • Schedule visits to your dentist up to twice a year. Your teeth and gums require regular dental cleaning and evaluation. The earlier oral conditions are diagnosed, the quicker they can be treated before they become severe.
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