Originally published November 2020. Updated November 2021.
As of 2018, the Centers for Disease Control (CDC) estimated that 34.2 million people in the U.S. are living with diabetes, with 7.3 million adults not even realizing they are diabetic. These are especially scary statistics given that most of us know diabetes can lead to a host of other health problems, from vision issues to kidney complications to cardiovascular disease.
But did you know that diabetes can also take a toll on the health of your smile?
Not only does it increase your risk for diseases that affect your teeth and gums but diminishing oral health can be one of the first signs of diabetes.
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What Is Diabetes?
Diabetes is a metabolic condition that affects your body’s ability to process and use glucose, the sugar in the blood that serves as our primary source of energy.
The body produces glucose from the food we consume and sends it to be used as energy by our cells. But glucose can’t reach these cells without the help of the hormone insulin. Without insulin, cells are unable to use glucose, and this causes high blood sugar – a condition that weakens our body’s defense against infections, including those in the mouth.
Type 1 vs Type 2 Diabetes
There are two primary types of diabetes: Type I and Type II.
With Type I (previously known as juvenile diabetes), the body doesn’t make enough insulin for the cells to get the glucose they need. The CDC estimates that between 5 and 10% of all diabetes cases are Type I, and the World Health Organization says the cause is currently unknown.
In cases of Type II diabetes, the body stops using insulin effectively over time. This accounts for an estimated 90-95% of diabetes diagnoses, which typically occur later in life than Type I. Primary risk factors include unhealthy diet, excess body weight, and physical inactivity.
Other less common types of diabetes include gestational, which occurs in some pregnant women and typically goes away after the baby is born. However, both the mother and child can have an increased risk for developing Type II diabetes later on.
There is also diabetes related to cystic fibrosis and monogenic diabetes, which is caused by a single gene mutation inherited from one or both parents.
How Are Diabetes and Oral Health Linked?
No matter which type of diabetes you have, you’re at an increased risk for developing issues that could affect nearly every part of the body, including the mouth. Even if you haven’t been diagnosed with diabetes, common dental problems such as gum inflammation could potentially be an early warning sign. Other signs of possible symptoms include:
Diabetes and Tooth Decay: Elevated glucose in our saliva supplies more food to the cavity-causing bacteria in dental plaque. As these bacteria multiply, they produce acid as a byproduct of their metabolism, increasing the rate and extent of tooth decay.
Diabetes and Gingivitis: Bacteria in plaque and tartar can cause swelling and bleeding along the gum line. Having high blood sugar increases your risk for gingivitis by compromising your body’s ability to fight infection.
Diabetes and Periodontal Disease: If gingivitis is left untreated, it can progress into advanced gum disease known as periodontitis. This condition is characterized by a loss of bone that supports the teeth. Periodontitis can contribute to spikes in blood sugar that makes diabetes more difficult to control and, in turn, gum disease harder to fight. It’s a vicious cycle that has led to periodontitis becoming the most common dental disease among those with diabetes, affecting roughly 22% of diabetics.
Periodontitis can also lead to tooth loss, with 1 in 5 cases linked to diabetes. What’s more, diabetes can impair blood flow, meaning the recovery period can be extended if you need oral surgery to treat gum disease.
Diabetes and Dry Mouth: Another symptom of diabetes can be dry mouth due to a lack of saliva. In some cases, this may result in difficulty swallowing, trouble speaking, a burning sensation, or a constant sore throat. Saliva is also incredibly important for clearing away food, bacteria, acid, and other disease-causing substances in the mouth. Without saliva, tooth decay and gum disease can more readily form.
Diabetes and Thrush: People with diabetes also have an increased risk for other infections in the mouth, particularly the fungal infection known as thrush. This causes painful red or white patches in the mouth which are made worse by smoking or high levels of sugar in your saliva.
Caring For Your Oral Health with Diabetes
The good news is that you can stay on top of your diabetes by taking doctor-prescribed medications, following a healthy diet plan, and getting regular exercise. By managing your blood sugar levels, you’ll also help lower your chance of developing oral health issues now and in the future.
Whether you have diabetes or not, it’s important to:
- Brush for two minutes twice a day with a soft bristled toothbrush and a fluoride toothpaste;
- Floss at least once a day, preferably before bed;
- Clean your denture each day if you wear one;
- Visit your dentist twice a year for regular cleanings;
- Avoid smoking;
Also, be sure to monitor any changes such as bleeding gums, dry mouth, or loose teeth and report them to your dentist as soon as you can. Make sure you also tell your physician of any new symptoms related to your mouth. There may not be a cure for diabetes, but with the right maintenance and treatment plans, you can enjoy a life of oral and overall health.
Sign up for MySmile® to check your benefits and help manage your diabetes – most of our plans cover cleanings and other preventative care procedures!
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