Dental Health and Diabetes: Unraveling the Relationship

Braden G. Barnett, MD

2022 Apr 21

10 min read

Diabetes and high blood sugar levels are two major conditions that cause different complications. The American Diabetes Association (ADA) makes it a priority to inform people about the effects of diabetes and how it’s a serious health risk. However, despite these warnings and orientations, diabetes is still one of the most popular conditions in the United States.

It’s estimated that up to 29.1 million people have diabetes in the US, with 1.7 million new cases diagnosed yearly. More shocking is that at least 8.1 million people in the country that have the condition are yet to be diagnosed and are currently yet to take any steps to manage the condition.

Despite the high number of people with diabetes and those who don’t know that they have the condition, many barely know that diabetes affects oral health. However, the American Diabetes Association (ADA) reveals the dangers of high blood sugar and how they contribute to various popular oral health problems. According to health institutions and experts, diabetes can increase fungal infections in the mouth and significantly cause gum and mouth pain.

This article aims to help people know how exactly diabetes affects dental health, the symptoms to look out for, and how they can start living a healthy life.

A Look Into Mouth and Gum Disease: Why Are People With Diabetes More Prone to Them?

diabetes and oral health

Naturally, diabetes is a condition known to cause different complications. However, there’s somewhat little awareness about its relationship with dental health.

According to experts, high blood sugar links diabetes and oral health. People with diabetes are extremely prone to high blood sugar, and those that experience spikes in their blood glucose more often are vulnerable to gum and dental infections.

Humans have loads of bacteria inside the mouth. These bacteria sometimes make their way to the teeth’ gum and enamel, leading to various oral infections like periodontal disease. These infections can become serious chronic inflammations, destroying the teeth gums, all active tissues that hold the teeth in place, and even the jawbones.

People with high blood sugar tend to produce the bacteria that could attack the teeth in extremely high numbers, making it much easier to penetrate the gum and entire part of the teeth.

What’s more, people with advanced diabetes that have become almost uncontrollable will experience even more significant effects of dental compromise. This is due to the extreme weakening of their white blood cells that are supposed to mount a defense against bacteria production and subsequent infections. At this stage of diabetes, nerve damage is possible, implying that the eyes and heart are also subject to several issues.

Dental infection worsens with age as diabetics from age 45 and above tend to have more devastating consequences than any other age category. It’s estimated that people with diabetes have a 22% higher chance of having periodontal disease than non-diabetics. Interestingly, this is only one of the multiple dental infections that diabetics are exposed to.

Dental infection for people with diabetes also has a boomerang effect as an increasingly infected mouth also causes a rise in blood sugar. With this being the case, it’s extremely likely for people with diabetes to have more serious health complications from either dental infections or diabetes than non-diabetics with oral health issues.

Symptoms of Dental Infections for People With Diabetes

There are several types of dental diseases that people with diabetes can experience. As a result, it’s often challenging to tell if their high blood sugar causes the oral disease.

However, meeting with a doctor can help them know if it’s an independent natural infection or a diabetes-triggered dental infection. One major way to tell is if you also have digestive and kidney diseases or any diabetes-related condition.

That said, here are the common dental problems directly related to high blood sugar levels.

Tooth Decay or Cavity

While the mouth already contains many bacteria, excessive intake of starchy and sugary foods only increases their production. These foods negatively interact with these bacteria such that they multiply in production and form a sticky, dull transparent film called plaques on the outside of the enamel.

As you continue to eat food that increases high blood sugar, the plaques only get harder, and the acid in them attacks the teeth’ enamel. A fungal infection is triggered in the plaque build-up process, leading to damage to the gum.

Cavity is an incredibly prevalent tooth condition in both diabetic and non-diabetic people. However, it’s extremely common with the former.

Early Gum and Dental Disease (Gingivitis)

Gingivitis—also known as early gum disease—develops as the plaque caused by high blood sugar hardens. While cavity is a possible complication from plaque hardening, gingivitis also damages the teeth somehow.

Gingivitis is a direct attack on the gum by plaques that harden under it. These plaques aren’t visible, and the damage is directly under them. The plaques get extremely hard and form a new substance called tartar.

Tartars, if left under the gumline, will cut into the gingiva—the teeth base—possibly leading to gum bleeding and swelling.

Periodontitis (Advanced Gum Disease)

Periodontal disease is the most popular dental condition that usually sends people to the dentist. People often try to perform self-management in the early stages of plaque build-up and minor gum bleeding. While some of these management treatments work, others don’t.

Lack of adequate gingivitis treatment will eventually lead to periodontitis — a condition characterized by the steady damage of the soft tissue and surrounding bones that hold the teeth. This severe gum disease leads to a shift in the gums and jawbones such that there’s no more support for the teeth.

The teeth base’s lack of support eventually leads to shaky teeth and a gradual shedding of teeth. People can lose all their teeth when periodontitis isn’t handled with serious care.

Periodontitis is often extremely severe for people who have diabetes. Diabetics have a compromised immune system and typically react poorly to infections with slowed-down healing.

Periodontitis also causes a rise in blood sugar levels which can cause people with diabetes mellitus to experience further complications like heart disease, kidney disease, and other cardiovascular issues.

Thrush

Another condition that people with diabetes can experience in terms of their dental health is thrush. While this condition doesn’t directly affect the teeth, it’s a fungal infection triggered by the development of the yeast Candida albicans. A major manifestation of thrush is white and sometimes red patches inside the mouth, which can be quite painful.

Thrush is more of a sign that blood sugar levels are on a high than it’s a serious source of pain. If you have diabetes and experience this condition, you likely have Candida albicans, directly formed from sugary and starchy foods.

Xerostomia (Dry Mouth)

Xerostomia is an oral condition directly related to high blood sugar. People that develop this condition tend to have a dry mouth that’s significantly uncomfortable and could lead to serious discomfort.

Due to low saliva levels, xerostomia results in a lack of liquid and moisture to keep the gum and teeth moisturized for long. The consequence is an increased vulnerability to gum damage.

The Way Out — Proper Dental Care

diabetes and dental care

If you’re a diabetic with gum disease, you’d need to treat your condition on two fronts. Namely, you’ll need to improve blood sugar control and ensure that you keep your teeth and gums healthy.

Doing this requires taking important proactive steps that aid diabetic disease control. In most cases, when you successfully manage your blood sugar, you’ll have fewer dental issues.

Below are steps you can take to care for your teeth.

Adopt a diabetes management plan

A vital step you can take to control your diabetes and reduce the risk of dental infection is to adopt a real diabetes management plan. This plan could be drawn out by your doctor or by an expert resource. Overall, the goal is to ensure that you eat the right food and start the right exercise.

As a diabetic, your eating habits should experience major lifestyle changes. Why’s that? The main cause of blood sugar rise is usually poor meal choices, so making a more informed and healthy food-eating choice can help you tackle a significant cause of blood glucose spikes.

Brush regularly with a moderate fluoride mouthwash

Experts advise that patients with dental infections brush more regularly with a mouthwash containing a safe amount of fluoride. While brushing twice a day is usually enough, patients can also floss daily for significant and effective cleaning.

Watch out for early signs and symptoms of gum disease

There are many early signs and symptoms that patients with gum disease can look out for, and being able to effectively decipher them is crucial to tackling the condition. For example, you could regularly check if there’s any dull film development on the surface of your teeth.

Don’t smoke.

Smoking is a major risk factor for diabetes and will only worsen your diabetes and dental infection. If you smoke, you should try to get professional help to quit, as your recovery may hinge on it.

How Can a Dentist Help You Deal With Possible Oral Disease?

dentist advice for diabetes patient

While there are multiple steps you can take to better your dental health, seeking professional help could be paramount. There’s a thin line between care and extremism, and most teeth floss and mouthwash products are significantly high in fluoride, such that they could lead to other health consequences. On the flip side, you can get the best recommendations and management tips to live a healthier life with a medical professional.

An excellent step in this regard is to adhere to regular dental visits to help you discover the healthiest ways to prevent gum disease and improve your oral health. If you already have serious dental complications that have affected your facial structure as a diabetic, an endocrinologist can help you recover better. Endocrinologists are immensely versed in dental and craniofacial research and have the best solutions for even the worst dental issues.

Apart from a dentist and endocrinologist, you should consider meeting a professional diabetes health expert to access the best management tips for good blood sugar control. It’s important that you share an extensive detail of your condition with your health practitioner. This enables quick recovery from your respective dental infection and helps you maintain safe blood glucose levels at every point in time.

Conclusion

Dental disease among diabetes is more common than it’s talked about. The somewhat unspoken awareness of the relationship between both conditions is rooted in the fact that dental conditions are usually considered stand-alone conditions and are treated independently. This extensive guide has shed light on how diabetes causes dental infection and how the latter can also lead to more high blood sugar spikes. 

As outlined in the above sections, one of the best ways to reduce the effect of diabetes from negatively influencing oral health is by taking measures that regulate high blood sugar. The guide also throws light on several lifestyle management tips that could drastically reduce blood sugar, with special consideration for the choice of food to eat.

Food plays an essential role in blood sugar level control, and this is why it’s important to seek counseling from a dietitian or an endocrinologist in selecting the right diet to effectively keep your blood sugar under control. Alternatively, you can opt for a diabetes meal planning app to help you with the best foods that don’t cause blood sugar spikes.

Our Klinio app is one of the top meal planner apps you can trust to expertly recommend foods that keep your blood sugar in check. There are tons of food to select from our virtual caregiver app, and you can easily plan your weekly and annual food schedule with it.

Written by

Braden G. Barnett, MD

Dr. Braden G. Barnett is an endocrinologist in Los Angeles, California and is affiliated with multiple hospitals in the area, including Keck Medical Center of USC and USC Norris Comprehensive Cancer Center. He received his medical degree from University of Southern California and has been in practice around 8 years. A skilled professional, Dr. Barnett holds certification from the American Board of Internal Medicine with a special focus on endocrinology, diabetes, and metabolism. He is also a recipient of several awards and honors.

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