Diabetes and dental care: Guide to a healthy mouth

Date Updated: 11/03/2020

When you have diabetes, high blood sugar can take a toll on your entire body — including your teeth and gums. The good news? Prevention is in your hands. Learn what you're up against, and then take charge of your dental health.

Cavities, gum disease and other problems

Whether you have type 1 diabetes or type 2 diabetes, managing your blood sugar level is key. The higher your blood sugar level, the higher your risk of:

Tooth decay (cavities). Your mouth naturally contains many types of bacteria. When starches and sugars in foods and beverages interact with these bacteria, a sticky film known as plaque forms on your teeth. The acids in plaque attack the surfaces of your teeth (enamel and dentin). This can lead to cavities and gum disease.

The higher your blood sugar level, the greater the supply of sugars and starches — and the more acid wearing away at your teeth.
Early gum disease (gingivitis). Diabetes reduces your ability to fight bacteria. If you don't remove plaque with regular brushing and flossing, it'll harden under your gumline into a substance called tartar (dental calculus).

The longer plaque and tartar remain on your teeth, the more they irritate the part of your gums around the base of your teeth, called the gingiva. In time, your gums become swollen and bleed easily. This is known as gingivitis.
Advanced gum disease (periodontitis). Left untreated, gingivitis can lead to a more serious infection called periodontitis, which destroys the soft tissue and bone that support your teeth. Eventually, periodontitis causes your gums and jawbone to pull away from your teeth, which in turn causes your teeth to loosen and possibly fall out.

Periodontitis tends to be more severe among people who have diabetes because diabetes lowers the ability to resist infection and slows healing. An infection such as periodontitis may also cause your blood sugar level to rise, which in turn makes your diabetes more difficult to control. Preventing and treating periodontitis with regular dental cleanings can help improve blood sugar control.
Thrush. People with diabetes may be more likely to develop thrush, which is a fungal infection caused by the yeast Candida albicans. Signs of thrush include painful white or red patches inside your mouth. Practicing good oral hygiene can help you avoid thrush.
Dry mouth (xerostomia). Some people with diabetes also experience a lack of saliva, a condition known as dry mouth. Without saliva to keep your mouth moist and bathe your teeth, you could be at risk of tooth decay, gum disease and thrush.

Proper dental care

To help prevent damage to your teeth and gums, take diabetes and dental care seriously:

Make a commitment to manage your diabetes. Monitor your blood sugar level, and follow your doctor's instructions for keeping your blood sugar level within your target range. The better you control your blood sugars, the less likely you are to develop gingivitis and other dental problems.
Brush your teeth at least twice a day. Brush in the morning, at night and, ideally, after meals and snacks. Use a soft-bristled toothbrush and toothpaste that contains fluoride. Avoid vigorous or harsh scrubbing, which can irritate your gums.

Consider using an electric toothbrush, especially if you have arthritis or other problems that make it difficult to brush well. Get a new toothbrush at least every three months.
Floss your teeth at least once a day. Flossing helps remove plaque between your teeth and under your gumline. If you have trouble getting dental floss through your teeth, use the waxed variety. If it's hard to manipulate the floss, use a floss holder.
Schedule regular dental visits. Visit your dentist at least twice a year for professional cleanings, X-rays and checkups.
Make sure your dentist knows you have diabetes. Every time you visit your dentist, remind him or her that you have diabetes. Make sure your dentist has contact information for your doctor who helps you manage your diabetes.
Look for early signs of gum disease. Report any signs of gum disease — including redness, swelling and bleeding gums — to your dentist. Also mention any other signs and symptoms, such as dry mouth, loose teeth or mouth pain.
Don't smoke. Smoking increases the risk of serious diabetes complications, including gum disease and ultimately, loss of your teeth. If you smoke, ask your doctor about options to help you quit.

Managing diabetes is a lifelong commitment, and that includes proper dental care. Your efforts will be rewarded with a lifetime of healthy teeth and gums.