Teeth and Diabetes

Guest Post from David Mapletoft, Diabetes Educator

Do people living with diabetes have more problems with the teeth than others?

Although a number of oral disorders have been associated with diabetes mellitus, the data support the fact that periodontitis is a complication of diabetes.

“People with diabetes who keep their blood glucose levels in a target range have no more dental problems than the rest of the population,” says Dr. Carol Alexopoulos, a dentist who practices in Canada.

However, people living with long standing, poorly managed diabetes are at risk of developing oral candidiasis, and the evidence indicates that periodontitis is a risk factor for poor glycemic control and the development of other clinical complications of diabetes.

The best predictor for severe periodontal disease in subjects with T2D is smoking followed by HbA1c levels. T2D subjects should be informed about the increased risk for periodontal disease when suffering from T2D according to this study 

Regular above target blood glucose levels can also lead to a decrease in saliva and an increase in salivary sugar, which leads to dry mouth, ulcers, fungal infections, increased tooth decay, loss of teeth, and difficulty wearing dentures.

Insufficient moisture can cause both dry mouth and a burning sensation on your tongue. This lack of moisture can eventually lead to an irritation of the entire lining of the mouth, since normal volumes of saliva actually protect your teeth from cavities and make chewing and speech comfortable. If you wear dentures and develop a feeling of dry mouth, you may find them irritating and more difficult to wear.

In addition, poorly managed blood glucose (sugar) levels can lead to:

  • Severe toothaches due to impaired circulation to your teeth. If you cannot eat solid food because chewing is difficult, try alternatives such as milk, soup, cereals, pudding, or fruit juices to replace your carbohydrate allowance.
  • More severe gum disease and at an earlier age.
  • Thickening of the small blood vessels of the gingiva (gums) which can lead to infection of the gum and bone tissues.
  • Periodontal disease that, in turn, can make it hard to manage blood glucose levels. Because periodontal disease is an infection, bacteria produce toxins that affect the carbohydrate metabolism in individual cells. It is also thought that the host response to periodontal bacteria can increase insulin resistance and, therefore, blood glucose levels.
  • A narrowing of the blood vessels including those in the mouth which can reduce blood supply to the gums therefore increasing the risk of infection
  • A gathering of sugars in the gingival fluid (the fluid between the tooth and gums) which can increase your risk of developing dental cavities.
  • Fungal mouth infections such as thrush. Thrush appears as white (sometimes red) patches in the mouth and on the tongue. These patches can get sore and turn into ulcers.Well-controlled blood glucose levels help to avoid thrush. Not smoking and, if you have dentures, taking them out at night also help. See your doctor for treatment if thrush develops.


 Regular Dental Visits
  • Visit your dentist at least once every six months to prevent minor problems becoming major ones.
  • Professional cleaning helps remove tartar build-up in areas not reached with regular brushing and flossing.
  • Remind your dentist you have diabetes at every visit.

There is also some evidence that dental disease is associated with an increased risk of coronary heart disease, particularly in young men.

More here Better Health Channel – “Diabetes and Oral Health”

American Diabetes Association ” Periodontal Disease ” video

Kind Regards,

David, Diabetes Educator



  1. neil on March 30, 2015 at 10:37 am

    I have a brother and brother inlaw who are type2 and do not take their condition seriously. They are both strongwilled and at times one does look very unwell . What is the best approach to take with them.

    • helwild on March 30, 2015 at 4:14 pm

      Hello Neil.:-) Do you have diabetes yourself? Are your brother and brother in law both adults? How well do you get along with them? Do you live or work together? How often do you see them both? How is your own health? Regards Helen Wilde Senior Counsellor

  2. neil on March 30, 2015 at 10:08 pm

    My brother lives interstate and inlaw we see regularly. Do not see much of my brother but when visiting him it is plain to see he does not take his condition seriously. Sometimes when my inlaw comes to visit he looks so sick. if I comment on this I become public enemy no.1 with him and my wife. I am not a diabetic but an aunt was and she was quite vigilant about when and what type of food to eat. Maybe she was over vigilant making me the same way. With my inlaw acting this way it puts pressure on my wife because of worry.I am not sure whether to step up and try to get these guys on the right track or stay in the background and support my wife when she needs it

  3. DavidMapletoft on April 2, 2015 at 3:15 pm

    @neil Difficult situation. The best thing you can do in my opinion is tell them how much you care about them, that you are concerned for their health, and the future health of their families i.e. if they are not caring for themselves, the family is likely to suffer in the future. 

    One strategy I sometimes use in my education sessions is to ask the question: “what is it that you are passionate about’ and then ask what physical attributes one  needs to participate in this passion. Poorly managed diabetes  can effect everything. Sometimes this awareness makes people sit up and start to self care better. 

    Its also a fine line between ‘supporting’ and ‘nagging’ 

    Good luck with your supporting neil.