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Diabetes Increases Oral Health Dangers

Patients should heed warning signs, tips for infection prevention

The Connection Between Diabetes & Oral Health

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Daily dental care and regular checkups should be part of routine diabetes management.

Most diabetics are keenly aware of the elevated health risks they face because of their condition, but potential dangers lurking in their mouths might not be foremost on their minds. 

Yet diabetics are more at risk for developing infections, and mouths are particularly prone to bacteria and thus fertile ground for problems, periodontist Sally Cram tells AARP. Dry mouth — another symptom of diabetes — also can cause dental issues because the enzymes in saliva help to kill plaque. Additionally, people with dry mouth may suck on hard candy for moisture, which puts them at risk of tooth decay and infection, says Cram, a spokesperson and consumer adviser for the American Dental Association (ADA).



Diabetes and periodontal disease are closely associated, and the cause and effect goes in both directions. "If a patient has untreated/unstable periodontal disease, they have chronic inflammation," Cram says. This can raise blood sugar levels and weaken the immune system, making patients more at risk for getting diabetes, or making it harder to control existing diabetes. This is especially true for people who have a family history of diabetes, or predisposing factors like obesity and poor diet. 

The tricky part of periodontal disease, which is low-grade infection in and around the gums, bones and teeth, is that it may not cause pain at first or could hurt only for a short time and then seem to get better. But if left untreated, the infection could still be building under your gums. "If you catch it in the early stages, many times you can do conservative treatment and that will reverse [the damage.] When it is more advanced, gum surgery or extracting teeth may be necessary," Cram says. 

Infection warning signs to watch for include:

  • Frequent abscess around teeth. 
  • Sore bleeding gums, despite good home care.
  • Redness in the gums.
  • Loose teeth. 

Tips for prevention

To combat the risk, diabetics should be impeccable with their home dental care. Cram recommends brushing twice a day and flossing at least once per day. "Diabetics should make this a part of their regular routine, just like checking their blood sugar, insulin and other preventative measures. Ninety-nine percent of dental problems can be totally avoided with regular oral hygiene."

Going to the dentist for frequent checkups is also key to catching issues before they become painful and expensive projects. "That might mean going to the dentist more than twice a year for diabetics because they are more prone to get periodontal disease," Cram says.

Diabetics should also make sure their practitioner has a full picture of their overall health. "Often patients don't want to fill out a medical history — they don't understand why a dentist needs that information," Cram says. However, dentists need to know what medications you are on and how well maintained your diabetes is before they prescribe treatment plans. 

The ADA offers a consumer website with a diabetes section and dental health symptoms to watch out for as you age. It is also working with member dentists to raise awareness of an in-office screening procedure that aids in the diagnosis of prediabetes and diabetes. 

Gum disease and cancer

There is a new study that also links gum disease with a 14 percent higher risk of cancer in older women, even if they never smoked. The increased risk was highest for esophageal cancer, followed by gallbladder cancer, which had never previously been associated with gum disease, according to researchers at the State University of New York at Buffalo. Periodontal disease was also associated with a higher risk of lung cancer, melanoma and breast cancer. The study, published in the August issue of the medical journal Cancer Epidemiology, Biomarkers & Prevention, analyzed health questionnaires from 65,000 postmenopausal women.

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