Diabetes and Gum (Periodontal) Disease
Diabetes that isn't controlled well can lead to gum (periodontal) disease. This can
happen at any age. Gum disease is an infection of the gums and the bones that hold
the teeth in place.
How diabetes affects mouth health
Diabetes causes changes to blood vessels. This affects the flow of nutrients to your
body tissues. It affects how waste is removed from tissues. This can weaken the gums
and jaw bone. It can raise your risk for infection.
If diabetes isn’t controlled well, higher blood sugar levels in saliva will help bacteria
grow. This can cause gum disease. Poor blood sugar control makes it harder for your
immune system to fight gum disease. And gum disease may make it harder to control
Smoking is a third factor that’s harmful to oral health. If you have diabetes and
you smoke, you’re at a much higher risk for gum disease than a person who doesn't
What are the symptoms of gum disease?
These are the most common symptoms of gum disease:
Red, swollen, sore gums
Bleeding while brushing, flossing, or both
Loose or separating teeth
Ongoing (chronic) bad breath or a strange taste in your mouth
Dentures that no longer fit
Pus between the teeth and gums
A change in bite and jaw alignment
The symptoms of gum disease may look like other conditions. Talk with a dentist or
other oral health specialist for a diagnosis.
What are the types of gum disease?
Gum disease is staged when the dentist assesses it. The stages are:
Gingivitis. This is the mildest form of gum disease. The gums become red, swollen, and sore.
They may bleed easily during daily cleaning and flossing. Treatment by a dentist and
good care at home help stop gingivitis.
Mild periodontitis. Untreated gingivitis leads to mild periodontitis. In this stage of gum disease, gums
pull away from the teeth. This causes a pocket between the teeth and gums. Bacteria
can settle here. This can lead to early loss of bone around the teeth. Quick medical
care can stop more damage.
Moderate to advanced periodontitis. This is the most advanced stage of gum disease. There is major bone loss, deepening
of gum pockets, and may be receding gums around the teeth. Your teeth may move and
change how you bite. Teeth may loosen and need to be pulled.
Treatment for gum disease
Treatment may include any of these:
Deep cleaning. This means tartar and plaque removal beneath the gums. It's also called scaling and
root planing. It can help remove the plaque and tartar under the gums. It can remove
infected tissue in the early stages of the disease. It can smooth the damaged root
surfaces of the teeth. The gums can then reattach to the teeth.
Medicine. Antibacterial medicines may be put in the gum pockets. Or you may take this medicine
Surgery. When the disease is advanced, the dentist will clean the infected areas under the
gums. Then they will reshape or replace the tissues. Types of surgeries include:
A regeneration procedure
A soft-tissue graft
Dental implants. These can permanently replace teeth that have been extracted. They can also serve
as an anchor for dentures. If you have dentures, they should fit well and not be loose.
Other oral problems from diabetes
Diabetes can cause other oral problems. These include:
Thrush. Thrush is a fungal infection of the mouth. It happens more often in people with diabetes.
This is because of high blood sugar in the saliva. Fungus thrives on sugar.
Burning feeling. Uncontrolled blood sugar can cause a burning feeling in your mouth.
Dry mouth. Dry mouth is often a symptom of undiagnosed diabetes. It means the mouth doesn't have
enough saliva to keep itself wet. Saliva helps digest food. It also helps prevent
infection and tooth decay. It does this by controlling bacteria and fungi. Dry mouth
can make it harder to taste, chew, and swallow food. It can affect how you speak.
It can cause mouth infections and tooth decay.
Symptoms of dry mouth may include sticky, dry mouth, dry lips, sense of burning in
the mouth, rough tongue, and mouth sores or infection.
To help prevent dry mouth symptoms:
Take frequent sips of water or sugarless fluids.
Drink fluids during meals.
Don't drink caffeine.
Don't eat spicy or salty foods.
Don't use tobacco or drink alcohol.
Use a humidifier at night.
Chew sugarless gum or sugarless candy.
Use medicine your dentist may prescribe to help keep your mouth moist.
How to brush and floss well
Good care of your teeth and gums can help prevent oral problems linked to diabetes.
These tooth brushing and flossing tips are advised by the National Institutes of Diabetes
and Digestive and Kidney Diseases:
Brush 2 to 3 times daily with a soft, nylon brush with rounded bristles and fluoride
Use small, circular motions and short back-and-forth motions. Don't use hard back-and-forth
Brush your tongue each time you brush your teeth.
Brush for about 3 minutes to clean all of the teeth well.
Brush the top, back, and front of each tooth.
Use about 18 inches of dental floss each time you floss.
Floss at least 1 time a day.
Don't use a sawing motion in between the teeth.
Curve the floss around each tooth and scrape up and down several times, from below
the gum to the top of the tooth.
Rinse after flossing.
Talking with your dentist
Your dentist is part of your diabetes management team. Tell your dentist about changes
in your health or medicines at each visit. You can tell them your diabetes test results.
This includes your A1C test results or your fasting blood glucose test results. This
can help the dentist better manage your dental care. If your diabetes isn’t controlled
well, ask your dentist if you need antibiotics before and after dental treatment.