Diabetes & Oral Health

People who have diabetes know the disease can harm the eyes, nerves, kidneys, heart and other important systems in the body. Did you know diabetes can also cause problems in your mouth?

People with diabetes are at special risk for periodontal (gum) disease, an infection of the gum and bone that hold the teeth in place. Periodontal disease can lead to painful chewing difficulties and even tooth loss. Dry mouth, often a symptom of undetected diabetes, can cause soreness, ulcers, infections, and tooth decay. Smoking makes these problems worse.

What can I do?

Good blood glucose control is key to controlling and preventing mouth problems. People with poor blood glucose control get gum disease more often and more severely than people whose diabetes is well controlled. Daily brushing and flossing, regular dental check-ups and good blood glucose control are the best defense against the oral complications of diabetes.

What are diabetes problems?

Too much glucose in the blood for a long time can cause diabetes problems. This high blood glucose, also called blood sugar, can damage many parts of the body, such as the heart, blood vessels, eyes, and kidneys. Heart and blood vessel disease can lead to heart attacks and strokes. You can do a lot to prevent or slow down diabetes problems.

High blood glucose can cause tooth and gum problems.

This information is about the tooth and gum problems caused by diabetes. You will learn what you can do each day and during each year to stay healthy and prevent diabetes problems.

What should I do each day to stay healthy with diabetes?

How can diabetes hurt my teeth and gums?

Tooth and gum problems can happen to anyone. A sticky film full of germs, called plaque, builds up on your teeth. High blood glucose helps germs, also called bacteria, grow. Then you can get red, sore, and swollen gums that bleed when you brush your teeth.

People with diabetes can have tooth and gum problems more often if their blood glucose stays high. High blood glucose can make tooth and gum problems worse. You can even lose your teeth.

Smoking makes it more likely for you to get a bad case of gum disease, especially if you have diabetes and are age 45 or older.

Red, sore, and bleeding gums are the first sign of gum disease. These problems can lead to periodontitis. Periodontitis is an infection in the gums and the bone that holds the teeth in place. If the infection gets worse, your gums may pull away from your teeth, making your teeth look long.

Call your dentist if you think you have problems with your teeth or gums.

Check your teeth and gums for signs of problems from diabetes.

How do I know if I have damage to my teeth and gums?

If you have one or more of these problems, you may have tooth and gum damage from diabetes:

• red, sore, swollen gums
• bleeding gums
• gums pulling away from your teeth so your teeth look long
• loose or sensitive teeth
• bad breath
• a bite that feels different
• dentures—false teeth—that do not fit well

How can I keep my teeth and gums healthy?

• Keep your blood glucose as close to normal as possible.
• Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times.
• Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth.

Brush and floss your teeth every day.

• If you wear false teeth, keep them clean.
• Call your dentist right away if you have problems with your teeth and gums.
• Call your dentist if you have red, sore, or bleeding gums; gums that are pulling away from your teeth; a sore tooth that could be infected; or soreness from your dentures.
• Get your teeth cleaned and your gums checked by your dentist twice a year.
• If your dentist tells you about a problem, take care of it right away.
• Be sure your dentist knows that you have diabetes.
• If you smoke, talk with your doctor about ways to quit smoking.

How can my dentist take care of my teeth and gums?

Your dentist can help you take care of your teeth and gums by

• cleaning and checking your teeth twice a year
• helping you learn the best way to brush and floss your teeth
• telling you if you have problems with your teeth or gums and what to do about them
• making sure your false teeth fit well

Get your teeth cleaned and checked twice a year.

Plan ahead. You may be taking a diabetes medicine that can cause low blood glucose, also called hypoglycemia. Talk with your doctor and dentist before the visit about the best way to take care of your blood glucose during the dental work. You may need to bring some diabetes medicine and food with you to the dentist’s office.

If your mouth is sore after the dental work, you might not be able to eat or chew for several hours or days. For guidance on how to adjust your normal routine while your mouth is healing, ask your doctor

• what foods and drinks you should have
• how you should change your diabetes medicines
• how often you should check your blood glucose

Pronunciation Guide

hypoglycemia (HY-poh-gly-SEE-mee-uh)

periodontitis (PAIR-ee-oh-don-TY-tiss)

plaque (plak)

For More Information

Diabetes Teachers (nurses, dietitians, pharmacists, and other health professionals)

To find a diabetes teacher near you, call the American Association of Diabetes Educators toll-free at 1–800–TEAMUP4 (832–6874), or look on the Internet at www.diabeteseducator.org and click on “Find a Diabetes Educator.”

Dietitians

To find a dietitian near you, call the American Dietetic Association toll-free at 1–800–877–1600, or look on the Internet at www.eatright.org and click on “Find a Nutrition Professional.”

Government

The National Institute of Dental and Craniofacial Research (NIDCR) is part of the National Institutes of Health. To learn more about tooth and gum problems, write or call the NIDCR’s information clearinghouse, the National Oral Health Information Clearinghouse (NOHIC), at 1 NOHIC Way, Bethesda, MD 20892–3500, 301–402–7364; or see https://www.nidcr.nih.gov/health-info on the Internet.

To get more information about taking care of diabetes, contact

National Diabetes Information Clearinghouse
1 Information Way
Bethesda, MD 20892–3560
Phone: 1–800–860–8747
Fax: 703–738–4929
Email: ndic@info.niddk.nih.gov
Internet: www.diabetes.niddk.nih.gov

National Diabetes Education Program
1 Diabetes Way
Bethesda, MD 20892–3560
Phone: 1–800–438–5383
Fax: 703–738–4929
Internet: www.ndep.nih.gov

American Diabetes Association
1701 North Beauregard Street
Alexandria, VA 22311
Phone: 1–800–DIABETES (342–2383)
Internet: www.diabetes.org

Juvenile Diabetes Research Foundation International
120 Wall Street
New York, NY 10005–4001
Phone: 1–800–533–CURE (2873)
Internet: www.jdrf.org