Diabetes and oral health impact each other in ways that the general public may not often consider. Compared to the broader population, individuals with diabetes face greater risk of periodontal disease, which may begin with inflamed gums and bleeding. Unchecked, this condition can progress to tooth loss. Moreover, managing diabetes becomes more challenging in the presence of periodontal disease, as it can cause systemic inflammation and other troubles which throw a spanner in the works of blood glucose level control.

Diabetics may have reduced saliva and slower wound healing, making them more susceptible to oral issues. Some difficulties which can result from this include dry mouth, fungal infections and prolonged recovery from dental procedures. Therefore, prioritising regular oral hygiene, dental check-ups and maintaining blood glucose levels is crucial for comprehensive diabetes care.

Does diabetes impact the oral microbiome?

Microbial Imbalance

When diabetes is controlled poorly, it can cause saliva to become high in glucose. This creates an ideal environment for oral bacteria to thrive, as such saliva becomes a nutrient source boosting bacterial growth and disrupting the delicate bacterial balance needed for good oral health.

Increased majority of particular species

Individuals with diabetes commonly exhibit higher levels of specific bacteria, including Streptococcus mutans and Candida albicans. These bacteria are linked to an increased susceptibility to oral conditions such as cavities and oral thrush.

Periodontal disease

The accumulation of dental plaque, a bacterial biofilm, is a key factor in periodontal disease. For individuals with diabetes, persistent high blood sugar adds to the challenge by creating a more inflammatory environment, accelerating the progression of gum disease. This emphasises the crucial role of oral care in diabetes management.

Impact on systemic health

Recent research suggests a link between the oral microbiome and systemic conditions like diabetes. Disruptions in the oral microbiome may contribute to systemic inflammation, affecting the overall health of individuals managing diabetes. Recognising this connection underscores the importance of oral health in the broader context of overall well-being.

Who is at high risk?

Poorly controlled diabetes

The risk of developing periodontal disease, which intensifes the severity of oral health issues, is heightened when blood glucose levels are inadequately managed. Consistent spikes in blood sugar contribute to an environment conducive to oral problems, such as gum inflammation, tooth decay, and increased risk of periodontal disease.

Long-standing diabetes

Individuals with diabetes over an extended period face cumulative effects. Prolonged exposure to fluctuating blood glucose levels can progressively impact oral tissues, necessitating heightened attention to preventive measures.

Smokers and tobacco users

Smoking impedes blood circulation and weakens the immune system, making individuals more susceptible to infections, including those affecting the oral cavity. Tobacco use exacerbates the challenges of managing diabetes and oral health.

female smoker

Family history or genetic predisposition

Those with a family history of diabetes or a genetic predisposition may inherit a higher susceptibility to both diabetes and associated oral health complications. Genetic factors play a role in shaping an individual’s predisposition to these conditions.

Age

Older individuals, with prolonged exposure to potential risk factors, may experience a cumulative impact on their oral health. Ageing adds another layer to the complexity of managing diabetes-related oral health challenges.

Coexisting medical conditions

Individuals with other medical conditions, such as cardiovascular diseases or obesity, face compounded risks. The interplay of multiple health issues can amplify the impact on oral health when diabetes is in the mix.

Challenges in maintaining a healthy lifestyle

Difficulty in maintaining regular dental check-ups and effective oral hygiene practices can further exacerbate the risk. Lifestyle challenges add an extra layer of complexity, requiring tailored strategies for oral health and diabetes management.

What are the symptoms?

The symptoms of diabetes-related oral health issues can vary, but common signs include:

Gum disease (periodontitis):

  • Inflamed, red or swollen gums
  • Gums that bleed easily, especially during brushing or flossing
  • Receding gums or gums pulling away from the teeth
  • Pus between the teeth and gums
  • Persistent bad breath
  • Changes in the alignment of teeth or the fit of dentures
  • Tooth decay (dental caries):

  • Tooth sensitivity
  • Toothaches
  • Visible cavities or holes in the teeth
  • Darkening or staining of the teeth
  • Dry mouth (xerostomia):

  • Persistent dry feeling in the mouth
  • Difficulty swallowing or speaking
  • Increased susceptibility to tooth decay and gum problems
  • Oral thrush (fungal infection):

  • White or red patches on the tongue, inner cheeks or gums
  • Painful or burning sensation
  • Difficulty in swallowing
  • Oral thrush

    Delayed wound healing:

  • Slow healing of cuts, sores or wounds in the mouth after dental procedures
  • Increased risk of infections in oral wounds
  • Altered taste (dysgeusia):

  • Changes in the sense of taste, making food taste different or less flavorful
  • How can you prevent or reduce oral complications?

    Optimal diabetes management

    Blood glucose control: Maintaining optimal blood glucose levels is fundamental to preventing diabetes-related oral complications. Your consistent monitoring and adherence to a diabetes management plan are essential components of this strategy.

    Collaborative care: Adopting a collaborative approach involving healthcare professionals, including dentists, ensures comprehensive care. Regular communication between your diabetes care providers and dental professionals enables a holistic management strategy.

    Oral hygiene practices

    Regular brushing and flossing: Establishing a robust oral hygiene routine is critical. Ensure you brush your teeth at least twice a day with fluoride toothpaste and regularly floss to prevent the accumulation of plaque.

    Dental check-ups: Regular dental check-ups, recommended every six months, are integral for proactive oral health management. During these check-ups, your dentist will conduct thorough cleanings to remove plaque and tartar, assess periodontal health, detect cavities and screen for oral cancer. The early identification of emerging issues enables timely intervention, preventing the progression of dental problems.

    These check-ups offer personalised guidance on your oral hygiene practices and lifestyle factors, contributing to optimal oral health. Beyond preserving your teeth and preventing complications, regular dental visits play a crucial role in educating you about the interplay between diabetes and oral health, promoting holistic well-being.

    Lifestyle modifications

    Healthy dietary habits: A balanced diet low in sugar contributes to better oral health. Minimise your intake of sugary snacks and beverages to help reduce the risk of tooth decay and gum disease.

    Hydration: Drinking fluoridated water helps maintain saliva flow, offering protection against dry mouth, a common oral complication in diabetes.

    Smoking cessation

    Cigarette-free lifestyle: For individuals with diabetes, quitting smoking is crucial. Smoking compromises oral health, impedes blood circulation and weakens the immune system, intensifying the risk of gum disease. Quit smoking for better oral and overall health.

    Take charge of your smile

    Dental check up

    Now that you know how closely tied diabetes is to oral health, it goes to follow that you will take every step toward holistic care. Regular dental check-ups, maintaining effective oral hygiene practices and keeping control over your blood glucose levels are essential steps, not only in preventing and managing potential oral complications but also in comprehensively managing your diabetes. These proactive measures safeguard your oral health and contribute significantly to your overall quality of life.

    Remember, your commitment to both managing diabetes and dedicated oral care lays the groundwork for a robust and thriving life. Recognising the complex link between diabetes and oral well-being highlights the importance of a well-rounded approach. By prioritising these practices, you empower yourself to minimise the impact of diabetes-related oral challenges, ensuring a healthier and more vibrant you.