Oral & Dental Complications

Oral and dental complications: an introduction

Oral and dental complications are common in people with diabetes. In fact, according to the National Health and Nutrition Examination Survey (NHANES), people in the US who have diabetes are twice as likely to develop gum disease compared to those without diabetes.1,2

Because oral and dental complications affect your ability to eat, these problems can have an impact on your ability control your blood sugar. Oral and dental complications include a wide variety of conditions, from gum disease and dry mouth to fungal and bacterial infections. If you have diabetes, one of your most important tools in staying health is your eating habits. Therefore, it is very important to know the keys to oral and dental health and to respond to minor problems in a timely manner so they don’t become serious ones.

Affect of diabetes on oral and dental health



Weakened small blood vessels
  • High blood glucose weakens small blood vessels throughout the body, including in the mouth
  • This compromises the health of the gums, promoting gum disease and slower healing of the gums
Diminished ability to fight infection
  • Diabetes is associated with diminished ability of white blood cells to fight bacterial infections, including those in the mouth
Dry mouth
  • Diabetes is associated with dry mouth (xerostomia), which involves decreased saliva production
  • Since normal saliva production is important for oral health, if you have dry mouth, you are more likely to get cavities and oral infections (fungal and bacterial)

How does diabetes affect oral and dental health?

Diabetes can affect the health of your mouth and teeth in several ways. Because elevated blood glucose weakens the small blood vessels throughout the body, when the small vessels of the mouth are affected, they become more likely to bleed and slower to heal, increasing the risk for development of gum disease. Diabetes is associated with a condition called dry mouth (the medical term is xerostomia), which is thought to arise from damage to the autonomic nerves that control saliva production. Our mouths depend on a normal amount of saliva production for protection against cavities and oral infections. Therefore, people who have dry mouth are at greater risk for getting cavities and oral infections (fungal and bacterial). Additionally, diabetes negatively affects our ability to fight off infections in the mouth. In people with diabetes, the white blood cells—the cells that are a key part of our immune system—appear to be less able to fight infection by bacteria than in people without the disease.3

What is gum disease?

Gum disease (also called periodontal disease, gingivitis, or periodontitis) involves the breakdown of the gum and bone that surrounds and supports the teeth. Normally, the root of the tooth is encased in bone. Gum wraps around and covers the bone and extends all the way to where the crown of the tooth is visible above the gum line. The space between the gum and the tooth is called the periodontal pocket. This is the space where the material called plaque and tartar (also called calculus) build up on the tooth. Plaque is the soft substance that you can remove by yourself via brushing and flossing. Tartar is a harder substance that your dentist removes during routine cleanings. The plaque and tartar form an environment that is rich in bacteria and, if they are not removed by flossing and brushing and by regular cleaning by a dental professional, they can cause irritation of the gums.3

In the earliest stages of gum disease, the gums are red and swollen and may bleed easily. If the teeth are cleaned, the gums will return to normal. However, if gum disease is allowed to progress, it can result in a receding of the gums, loss of bone around the root of the teeth, and exposure of the roots of the teeth. In advanced gum disease, the teeth become loose and may need to be extracted.3

How can gum disease be prevented?

If you have diabetes, you are at greater risk for developing gum disease. Due to changes that occur with diabetes, you may experience recession of your gums and bone loss, even without accumulation of plaque and tartar. If you allow plaque and tartar to build up, gum disease is likely to progress much more quickly than in someone without diabetes. This means that you must be particularly careful about removing plaque by flossing and brushing and removing tartar by having your teeth cleaned regularly. You should have a check-up and cleaning every 3 to 6 months. Talk to your dentist about the best way to prevent gum disease and whether you might benefit from an electric toothbrush or a prescription mouth rinse designed to eliminate build-up of bacteria around the gum line.

What can I do about dry mouth

?Dry mouth can make you more susceptible to getting cavities. Your dentist may want to use fluoride gels or rinses to help strengthen your teeth. Talk to your dentist about using an artificial saliva product if you experience severe dry mouth. Artificial saliva can help you with eating and speaking. Drinking water (sipping a little water throughout the day) can also be helpful if you have dry mouth, as well as chewing sugarless gum after meals. Sugarless gum can increase saliva production and protect against the formation of cavities.

Written by: Jonathan Simmons | Last reviewed: May 2014.
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