The relationship between diabetes and oral health does not run in one direction only. High blood sugar increases problems in the mouth; inflammation in the mouth in turn makes blood sugar harder to control.
How does diabetes affect the mouth?
Gum disease
Gum disease is more common in people with diabetes and progresses faster. High blood sugar reduces the body's ability to fight infection, affects the small blood vessels and slows healing.
Dry mouth
When there is less saliva the teeth are left unprotected against acid; decay, mouth sores and sore spots from dentures increase.
Fungal infection
Sugar in the saliva and a dry mouth set the stage for the fungal infection known as thrush. It is seen especially in people who wear removable dentures.
Slow healing
After extractions and surgical procedures, wounds close more slowly and the risk of infection is higher.
Changes in taste and a burning feeling
Some people experience a burning feeling in the mouth or changes in taste.
Does gum disease affect blood sugar?
Yes. Advanced gum disease is a constant source of inflammation in the body and can reduce the effect of insulin. Research shows that gum treatment can make a positive contribution to blood sugar control in people with diabetes. So gum health should be seen as part of diabetes care.
Signs to watch for
- Gums that bleed on brushing, or are red or swollen
- Bad breath that does not go away
- Receding gums, loose teeth
- A constantly dry mouth
- White patches on the tongue or inside the cheek that can be wiped off
- Mouth sores that do not heal
These signs can sometimes also be the first indication of diabetes that has not yet been diagnosed.
Oral care for people with diabetes
- Keep your blood sugar under controlThis is the most effective thing you can do for your oral health.
- Brush twice a day and clean between your teeth every dayUse a soft brush and fluoride toothpaste.
- Have check-ups more oftenA dental check-up every three to six months, with cleaning when needed, is recommended.
- Take steps against dry mouthDrink plenty of water, chew sugar-free gum and avoid alcohol-based mouthwashes.
- Keep your denture cleanClean a removable denture every day and take it out at night.
- Stop smokingSmoking and diabetes together multiply the risk of gum disease.
When you come for dental treatment
- Tell your dentist that you have diabetes, which medication you take and your latest HbA1c result.
- Book your appointment for a time when you have taken your medication and eaten, preferably in the morning.
- Do not come to the appointment on an empty stomach; carry a fast-acting source of sugar with you.
- For planned surgery and implants, blood sugar is expected to be under control; your doctor is consulted if needed.
- If your eating pattern will be disrupted after the procedure, ask your doctor about your medication dose.
Well-controlled diabetes is no obstacle to dental treatment or implants. What matters is that your blood sugar is stable and that your dentist knows about your condition.
For information on gum treatment, see our periodontology page.
Frequently asked questions
I have diabetes. Can I have an implant?
If your blood sugar is under control, in most cases yes. In uncontrolled diabetes healing is delayed and the risk of failure rises; so blood sugar is expected to be stabilised first.
How often should people with diabetes see a dentist?
Usually every three to six months. If you have a history of gum disease your dentist may recommend more frequent check-ups.
Should I stop my medication before an extraction?
No, do not stop or change your medication on your own. Tell your dentist what you take; if needed, the plan is made together with your doctor.
This article is for general information and is not a substitute for diagnosis or treatment. If you have a complaint, please see your dentist.