Diabetes and Gum (Periodontal) Disease
Diabetes that is not well controlled
can lead to gum (periodontal) disease. This can happen at any age. Gum disease is infection
of the gums and the bones that hold the teeth in place.
Diabetes causes changes to blood
vessels. This affects the flow of nutrients. It also affects how waste is removed from body
tissues. This can weaken the gums and bones and raise risk for infection.
Also, if diabetes is poorly
controlled, higher blood sugar levels in the mouth fluids will help bacteria grow that can
cause gum disease. Poor blood sugar control makes it harder for your immune system to fight
infections. Uncontrolled gum disease may also make it harder to control the diabetes.
Smoking is a third factor that is
harmful to oral health. This is true even for people without diabetes. But if you have
diabetes and you smoke, you are at a much greater risk for gum disease than a person who
doesn't have diabetes.
Along with poor oral hygiene, diabetes
can lead to gingivitis. This is the first stage of gum disease.
What are the symptoms of gum
These are the most common symptoms
of gum disease:
Red, swollen, tender gums
Bleeding while brushing,
flossing, or both
Loose or separating teeth
Chronic bad breath or a
strange taste in your mouth
Dentures that no longer fit
Pus between the teeth and gums
A change in bite and jaw alignment
The symptoms of gum disease may
look like other conditions. Talk with a dentist or other oral health specialist for a
What are the different types of gum
Gum disease is staged when the
dentist assesses it. The stages are:
Gingivitis. This is the
mildest form of gum disease. The gums are likely to become red, swollen, and
tender. They may bleed easily during daily cleanings and flossing. Treatment by a
dentist and proper, consistent care at home help to stop gingivitis.
Mild periodontitis. Untreated
gingivitis leads to mild periodontitis. In this stage of gum disease, gums pull
away from the teeth. This causes a pocket between the teeth and gums. Bacteria can
settle here. This can lead to early loss of bone around the teeth. Prompt medical
attention can stop more damage.
Moderate to advanced
periodontitis. This is the most advanced stage of gum disease. There is
major bone loss, deepening of gum pockets, and possibly receding gums around the
teeth. Teeth may loosen and need to be pulled.
Treatment for gum disease
Treatment may include any of the
Tartar and plaque removal beneath
the gums. Deep cleaning (also called scaling and root planing) can help
remove the plaque and tartar beneath the gum and infected tissue in the early
stages of the disease. It can also smooth the damaged root surfaces of the teeth.
The gums can then reattach to the teeth.
medicines may be put in the gum pockets. Or you may take this medicine by mouth
Surgery. When the disease is
advanced, the dentist will clean the infected areas under the gums. Then, he or
she will reshape or replace the tissues. Types of surgeries include:
A soft-tissue graft
Dental implants. If you have
false teeth (dentures), they should fit well and not be loose.
Diabetes and other oral problems
Diabetes can also cause other oral
problems. These include:
Thrush. Thrush is a fungal
infection of the mouth. It happens more often in people with diabetes because of
high blood sugar in the saliva. Fungus thrives on sugar.
Dry mouth. Dry mouth is often
a symptom of undetected diabetes. It means the mouth doesn't have enough saliva to
keep itself wet. Saliva helps digest food. It also helps prevent infection and
tooth decay by controlling bacteria and fungi. Dry mouth can make tasting,
chewing, and swallowing food difficult. It can also affect how you speak and cause
mouth infections and tooth decay.
Symptoms of dry mouth may
include sticky, dry mouth, dry lips, sense of burning in the mouth, rough tongue,
and mouth sores or infection.
Always talk with your healthcare provider for a diagnosis.
Treatment for dry mouth depends on the cause of the condition. Dry mouth can be caused by medicine, disease, cancer treatment or other salivary gland damage, and nerve damage. Some tips to prevent dry mouth symptoms include:
Take frequent sips of water or sugarless fluids.
Drink fluids during meals.
Stay away from spicy or
Don't use tobacco or
Use a humidifier at night.
Chew sugarless gum or sugarless candy.
Taking a medicine your dentist may prescribe that can help keep your mouth moist.
Preventing gum disease and other oral
Proper care of your teeth and gums
can go a long way to prevent oral problems linked to diabetes. The following tooth
brushing and flossing tips are recommended by the National Institutes of Diabetes and
Digestive and Kidney Diseases (NIDDK):
Brush twice daily with a soft, nylon brush with rounded bristles and fluoride toothpaste.
circular motions and short back-and-forth motions. Don't use hard
Brush the tongue each time you brush your teeth.
Brush for about 3 minutes to clean all of the teeth well.
Brush the top, back, and front of each tooth.
Use about 18
inches of dental floss each time you floss..
Floss at least
once a day.
a "sawing" motion in between the teeth.
Curve the floss around each tooth and scrape up and down several times, from below the gum to the top of the tooth.
Rinse after flossing.
Your dentist is part of your
diabetes management team. The NIDDK suggests that you alert your dentist to changes in
your health or medicines on each visit. Also, share some of your diabetes test results,
such as your A1C test or your fasting blood glucose test. This can help the dentist
better manage your dental care. Finally, if your diabetes is not well controlled, ask
your dentist if you need antibiotics before and after dental treatment.