Like every other part of your body, persistently high blood sugars can have a big impact on your teeth and your entire mouth.
Periodontal (mouth) diseases are considered the sixth most prevalent diabetes complication, according to a 2011 study. Fortunately, there are so many things you can do to protect your teeth and keep your mouth healthy.
In this article, we’ll discuss how diabetes affects the health of your mouth, the most common dental issues people with diabetes face, and what you can do to protect your own smile!
How diabetes affects your dental health
Your mouth is a complicated place! Gums, teeth, tongue, saliva, and tons of essential bacteria, nerves, roots, and blood cells. And it relies on that constant delivery of healthy blood to keep every detail of your mouth happy.
According to the American Dental Association (ADA), 22 percent of people with diabetes experience dental complications due to high blood sugars.
Signs of diabetes complications in your mouth and teeth include:
- Less saliva and overall dry mouth (certain medications can also cause dry mouth)
- Higher risk of cavities due to a reduction in saliva
- Higher risk of bone loss due to a reduction in saliva
- Higher risk of ulcers due to a reduction in saliva
- Inflamed, bleeding gums (diagnosed as gingivitis)
- Severe bone/tooth loss (which leads to needing dentures)
- Decreased ability to taste food
- Difficulty healing any injuries in your mouth
- Increased risk of infections
- Fungal infections (known as “thrush” — a yeast infection in your mouth) from excess glucose
- Burning sensation in mouth and tongue from “thrush”
- In children, teeth can “erupt” earlier than normal
The consequences of high blood sugars on the well-being of your mouth may start out as subtle and small, but they will eventually make themselves known.
And you’ll inevitably experience many of these symptoms rather than just one or two because they all result from the same thing: persistently high blood sugar levels.
Smoking cigarettes: adding fuel to the fire
When you add smoking or any type of tobacco use to diabetes, the consequences increase quickly. And your risk of developing every dental health disease on the list increases significantly.
For a person with diabetes — whose blood circulation is already compromised and whose nerve endings are already experiencing potential damage from higher than normal blood sugar levels — smoking cigarettes increases the consequences of high blood sugars on your teeth tremendously.
If you’re concerned about your dental and oral health as a person with diabetes, quitting smoking (or other tobacco habits) is critical in saving the teeth and gums you’ve got!
*For support in quitting smoking, visit SmokeFree.gov.
Most common dental health issues people with diabetes develop
There are a handful of truly serious health conditions people with diabetes can develop due to persistently high blood sugars.
While the idea of losing one tooth may be easy to ignore, these conditions can lead to chronic infections, severe bone and tooth loss, the need for dentures, and major surgery.
Periodontitis (also known as Gingivitis or “Gum Disease”)
Periodontitis is one of the most prevalent diseases across the globe, according to a 2011 study.
Surprisingly, it’s just as common in developed countries like the United States, Europe, Canada, etc. where brushing teeth is widely understood and adopted as it is in developing countries with little access to toothbrushes, toothpaste, and healthcare education.
Also known as gingivitis in its earlier stages, periodontitis is a chronic inflammatory disorder of the gums caused by an overgrowth of bacteria in your mouth.
While your mouth is expected to contain a tremendous variety of bacteria within the plaque that forms daily on your teeth, it can become overwhelming if you aren’t brushing your teeth regularly or due to other sources of inflammation and bacteria growth, like high blood sugar levels.
“Eventually, the toxins that are released by the microorganisms in the dental plaque will start the gingival inflammation as a result of failure to remove the dental plaque on a daily basis,” explained the study.
As the inflammation increases, a pocket begins to form within your gums. Eventually, that pocket can actually cause the gums to detach from the surface of your tooth.
“This periodontal pocket is filled with bacteria and its toxins. As the disease worsens, the pocket will get deeper carrying the dental plaque until it reaches the alveolar bone that will eventually be destroyed with the periodontal attachment.”
It can worsen your blood sugars
Research has found that untreated periodontitis in people with diabetes not only increases the risk of tooth loss, it also increases levels of insulin resistance.
It is well established that inflammation worsens insulin resistance which then increases blood sugar levels. As a condition that revolves around inflammation, it’s no surprise that periodontitis actually makes improving your blood sugars more difficult.
Research has shown that treating periodontitis with the help of a periodontist (which you’d be referred to by your dentist) has proven effective in actually improving overall blood sugar levels and in lowering a patient’s HbA1c.
How periodontitis is treated
Fortunately, if you take action early in the development of periodontitis and work with your healthcare team to improve your blood sugars, you can prevent this condition from taking your teeth!
The American Dental Association explains the treatment options for periodontitis depending on its severity:
Non-surgical “periodontal cleaning”: “The first nonsurgical step usually involves a special cleaning, called ‘scaling and root planning,’ to remove plaque and tartar deposits on the tooth and root surfaces.” This helps your gum tissue heal while the infected pockets also shrink.
Medications to control infection: “Your dentist also may recommend medications to help control infection and pain, or to aid in healing.” The medication may come in pill form, a liquid “rinse,” or a substance your dentist actually places within the infected pocket immediately after your periodontal cleaning.
Surgery: If the first two treatment steps aren’t adequate, the periodontal pockets will grow larger, providing the perfect environment for further bacteria growth while risking severe bone and tissue damage. At this point, your dentist will refer you to a periodontist. While you are sedated, the surgeon will be able to fully access the areas under your gums where the tartar, plaque, and bacteria have accumulated.
By removing the bacteria, your gums and teeth will be able to start healing. For severe bone or gum loss, your surgery may quire bone or soft-tissue grafts which are essential for rebuilding and reshaping what’s been destroyed by gum disease. This can also include wearing a splint or bite guards after surgery to provide stability to loose teeth and support your mouth as it heals.
Fungal infections (oral candidiasis or “oral thrush”)
Not unlike a vaginal yeast infection or athlete’s foot, a fungal infection in your mouth is an overgrowth of the fungus Candida albicans. While it’s expected to be found in the mouth, it can easily over-grow due to the presence of excess glucose (sugar).
When the amount of this fungus becomes overwhelming, it creates an infection.
The four most likely factors that can lead to an overgrowth of Candida albicans in your mouth are:
- Smoking cigarettes
- Xerostomia (dry mouth)
- Endocrine disorders (type 1 diabetes with high blood sugar levels)
- Metabolic disorders (type 2 diabetes with high blood sugar levels)
- Dentures
“Pseudomembranace candidosis” is also known as oral thrush, and is the most common in people with diabetes.
“It is characterized by the presence of a creamy white patch which, when wiped, reveals underlying erythematous and bleeding oral mucosa,” explained the study. “The soft palate is the most commonly affected area followed by the cheek, tongue, and gingivae.”
In some cases, other types of Candida fungus can accompany the Candida albicans species. These other types include C. dubliniensis, C. tropicalis, and C. parapsilosis.
Your healthcare team can determine which type(s) of fungus your body is struggling with by taking a sample to assess.
How fungal infection it’s treated
After being properly diagnosed by your healthcare team or dentist, it is very important to fully treat any type of Candida overgrowth because it can spread to other areas of your body if ignored.
There are numerous antifungal drugs your doctor or dentist can prescribe to manage and eliminate the excessive Candida fungus growth.
- Nystatin
- Ketoconazole
- Fluconazole
- Itraconazole
These drugs are generally taken orally in pill form.
Excessive amounts of glucose in your bloodstream feed the overgrowth of this fungus. To prevent it from recurring, working with your healthcare team to improve your blood sugar levels is critical.
Salivary dysfunction
You likely already know how much high blood sugar levels can leave your mouth desperately thirsty, dry, and even “cotton-mouthed” at its worst.
Persistently high blood sugars can develop two salivary issues known as “hyposalivation” (too little saliva) and “xerostomia” (dry mouth).
Research has found that these two conditions are highly common in the diabetes population compared to those with diabetes — especially in patients with neuropathy and other diabetes complications.
While a little thirst now and then has never been thought of as a threat to your health, your mouth relies on the constant presence of saliva to function properly.
Chronic high blood sugar levels that lead to chronic dry mouth create significant irritation in your gums, which is eventually followed by inflammation, pain, and an increased risk of gum disease, tooth decay (cavities), and pain.
How salivary dysfunction is treated
Quite simply, the only true treatment for this condition is to improve your blood sugar levels with the help of your healthcare team. Remember, properly treating periodontitis will have a positive impact on your blood sugars, too!
Taste dysfunction
While less of a threat to your overall health, losing the ability to fully taste your food as a result of persistently high blood sugar levels is likely accompanied by other dental health issues and should be taken seriously!
“Taste dysfunction has been reported to occur more frequently in patients with poorly controlled diabetes compared to healthy controls,” explains the research. “Diabetic patients who suffer from neuropathy have a higher taste threshold. Taste disturbance has also been reported to lead to poor glycaemic control by inhibiting the ability to maintain a good diet.”
How taste dysfunction is treated
Like salivary dysfunction, the only true treatment for this condition is to improve your blood sugar levels as quickly as possible. Talk to your healthcare team and your dentist about your concerns and take action!
Preventing and reducing your risk of experiencing any of the aforementioned oral health diseases is remarkably straightforward:
Strive to get your blood sugar levels into a healthy range. If you’re struggling to do this on your own, then it’s time to ask for help! It might be the addition of a new medication to help compensate for your body’s struggle to produce adequate amounts of insulin or an increase in your current medication or insulin regimen. You might also consider support from a health coach to improve lifestyle habits which will improve blood sugar levels.
Take good care of your teeth and gums — daily. Brushing your teeth at least twice a day is critical to preventing oral health disease. Every time you skip the 2-minute act of brushing your teeth, you’re letting food and bacteria accumulate, decay, and infect your mouth. Brush, brush, brush!
Visit your dentist for a cleaning every 6 months. Dental cleanings are so easy and truly painless! If you don’t have dental insurance, at least consider paying out-of-pocket for a cleaning once per year. Your gums and teeth will thank you.
Quit smoking. Just quit. Right now. Seek out all the support you can and rid your life of those poisonous, toxic little sticks. They are rotting every inch of your body — especially your teeth!
Wash dentures daily. If you currently wear dentures and you aren’t washing them daily, it’s time to incorporate denture cleanings into your daily routine. Just as you wouldn’t want to eat off the same dirty plate every day, you wouldn’t want to keep putting something covered in old food back into your mouth.
Take good care of that smile! It’s the only one you’ve got.
