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Diabetes affects many parts of your body, including your mouth. People with diabetes are more likely to have gum diseasecavities and other problems with their teeth and gums.1 And some of these oral problems can make your diabetes worse.
Taking good care of your teeth and gums, including regular cleanings and necessary treatments, will help prevent these problems or stop them from getting worse. Keeping your mouth healthy will also make it easier for you to manage your diabetes and prevent diabetes-related health problems, such as heart disease and kidney disease.1
How can diabetes affect my mouth?
Diabetes can affect your mouth by changing your saliva – the fluid that keeps your mouth moist. Saliva helps prevent tooth decay by washing away food particles, preventing bacterial growth, and fighting acids produced by bacteria. Saliva also has minerals that help protect the tissues in your mouth and fight tooth decay.
Diabetes and certain medications used to treat diabetes can cause the salivary glands in your mouth to produce less saliva. When less saliva flows, the risk for dental cavities, gum disease and other oral problems increases.
Diabetes can also increase the amount of glucose in your saliva. Diabetes occurs when your blood glucose level, also called blood sugar, is too high. High blood glucose levels can also cause glucose to build up in your saliva. This glucose can feed harmful bacteria that combine with food to form a soft, sticky film called plaque, which causes cavities. If you don’t remove plaque, it can also build up on your teeth near your gum line and harden into a deposit called tartar, which can cause gum disease.
Left untreated, these oral problems can lead to tooth loss. Nearly 25% of US adults with diabetes age 50 and older have severe tooth loss, compared with about 16% of those without diabetes.2
What are the most common oral problems from diabetes?
Gum disease
Gum disease, also called periodontal gingivitis, is the most common and serious oral problem associated with diabetes. Without treatment, the disease progresses in stages, from gum inflammation to tooth loss. High blood glucose levels increase the risk of gum disease progressing from mild to severe.1
Gingivitis, or inflammation of the gums
The first stage of gum disease is gingivitis, a mild inflammation of the soft tissues around your teeth. Gingivitis develops when plaque and calculus build up on your teeth near your gum line, irritating and inflaming your gums. As a result, your gums may become red and swollen and bleed easily.
Periodontitis
Left untreated, gingivitis can progress to periodontitis, an infection of the gums and bones that hold your teeth in place. Your gums can pull away from your teeth, forming pockets that slowly become infected. The bacteria in your mouth and your body’s reaction to the infection begin to break down the bone and tissue that hold your teeth in place. If periodontitis is not treated, the teeth can become loose and may even need to be removed.
Other common oral problems
In addition to gum disease, diabetes also increases your risk for3
- dental cavities
- dry mouth, lack of saliva which can cause sores, ulcers and infections
- chewing guma fungal infection that causes painful, white patches in your mouth
- burning mouth syndromea burning sensation in your mouth caused by uncontrolled blood glucose levels
- changes in the way food and drink taste
These oral problems, as well as tooth loss, can make it difficult for you to follow a healthy meal plan that will help you manage your diabetes.
How will I know if I have oral problems from diabetes?
Check your mouth for signs and symptoms of problems from diabetes, such as1
- gum where it is
- red, swollen or bleeding
- retreating
- pulling away from your teeth
- loose teeth
- increasing the spaces between your teeth
- dry mouth, an important sign of diabetes
- bad breath that doesn’t go away when you brush your teeth
What should I do if I have oral problems from diabetes?
See your dentist right away if you notice any signs or symptoms of oral problems. Your dentist is an important ally in keeping your mouth healthy and treating oral problems before they become serious.
If you have diabetes
- tell your dentist about your diabetes, including how long you’ve had the disease, any diabetes-related problems you may have, and any medications you take
- keep your dentist informed of any changes in your health, including any increase in your blood glucose levels
- ask how often you should come in for regular cleanings and check-ups
- follow your dentist’s advice on how to prevent and treat oral problems from diabetes
If you feel nervous about visiting the dentist, let your dentist and staff know about your feelings. Your dentist can tailor the treatment to your needs.
How can I prepare for dental work?
High blood glucose increases your risk for infections after oral surgery, and it can also take longer for your mouth to heal. Tell your doctor if you are going to have oral surgery or other extensive dental work. To help you prepare and heal after the procedure, ask your doctor
- how often you should check your blood glucose before and after the procedure
- what, if any, changes you need to make to your medications, such as changing the dose or time you take a medication
- how to best deal with any post-procedure pain;
How can I keep my mouth healthy?
Keep your mouth healthy (PDF, 242.78 KB) by doing these steps
- Keep your blood glucose numbers within your target range. Your doctor can help you set your goal and explain what to do if your numbers are too high or too low.
- Eat healthy meals and drinks and follow the meal plan you and your doctor or registered dietitian have worked out for you.
- Visit your dentist regularly. Ask your dentist how to take care of your teeth at home, including the cleaning tools and products you should use. Your dentist can recommend a cleaning routine tailored to your needs.
Taking good care of your teeth is not always easy. Challenges can include finding a dentist nearby who can help you develop a dental routine that works for you and being able to afford dental care and related products. If you’re worried about the cost, think about it free or low-cost dental care options;such as
- community health centers across the country that provide free or reduced-cost health services, including dental care.
- Medicaid, a government program that provides medical benefits to qualifying individuals and families. Most states offer limited dental services for adults, while some offer comprehensive services.
Don’t let these concerns stop you from getting regular checkups. Waiting too long to take care of your mouth can make things worse.
Smoking increases the risk of many diabetes and oral problems. If you smoke or use other tobacco products, stop. Ask for help so you don’t have to do it yourself. You can start by calling the National Quitline at 1-800-QUITNOW or 1-800-784-8669. For tips on how to stop smoking, visit Smokefree.gov.
Clinical trials for diabetes and gum disease
The NIDDK conducts and supports clinical trials in many diseases and conditions, including diabetes. Trials seek to find new ways to prevent, detect or treat disease and improve quality of life.
What are the clinical trials for diabetes and gum disease?
Clinical trials — and other types clinical studies— are part of medical research and involve people like you. When you volunteer to participate in a clinical study, you help doctors and researchers learn more about diseases and improve health care for people in the future.
Researchers are studying many aspects of diabetes and gum disease, including how certain genes may play a role in diabetes, gum disease, heart disease, and bone loss.
Find out if clinical studies are right for you.
Watch a video of NIDDK Director Dr. Griffin P. Rodgers explaining the importance of participating in clinical trials.
Which diabetes and gingivitis clinical trials are looking for participants?
You can find clinical studies on diabetes and gum disease at www.ClinicalTrials.gov. In addition to searching for federally funded studies, you can expand or narrow your search to include clinical studies from industry, universities, and individuals. However, the National Institutes of Health does not review these studies and cannot ensure that they are safe. Always talk to your healthcare provider before participating in a clinical study.