Dr Aidin Rawshani

Diabetes, gum disease and other dental problems


How can diabetes affect my mouth?

Diabetes is associated with elevated blood sugar levels. High blood sugar affects the blood vessels in the oral cavity negatively, just as the blood vessels in the heart, brain and lower limbs suffer extra damage from high blood sugar. Elevated blood sugar levels can cause infection and other problems in the oral cavity.

Oral cavity includes the following structures

  • Teeth
  • Gingival
  • Jaw bones
  • Tissues such as tongue, palate, mouth bottom, inside of your cheeks and salivary glands

Sugar (glucose) is in your saliva. Individuals with elevated blood sugar levels also have high concentrations of glucose in the saliva, which leads to the overgrowth of harmful bacteria in the oral cavity. When you chew the food, this is mixed with the bacteria, which then calluses and form plaques. Some types of plaque cause holes in the teeth, while other types of plaque cause gum disease and bad breath.

Diseases of gums can be more difficult and take longer to heal if you have diabetes. Having gum disease, in turn, can lead to your blood sugar becoming difficult to control.

What if I have plaque?

Plaque that is not removed by brushing or other methods will harden over time and eventually form tartar that accumulates above your gum line. Tartar makes it more difficult to brush and clean between teeth. Your gums turn red, swell a little and bleed easily, this is a sign of unhealthy or inflamed gums. Inflamed gums that bleed easily, reddened and slightly swollen are called gingivitis in medical language.

When gingivitis is not treated, the condition of the gums deteriorates and develops into a gum disease called periodontitis. In periodontitis, the gum detaches from the teeth and forms spaces, called pockets, which slowly become infected. This infection can last a long time. Your body fights the bacteria in plaques that spread and grow under the gums. Both the bacteria and the body’s reaction to the infection begin to break down the bone and tissue that holds the teeth in place. If periodontitis is not treated, the gums, bones and tissue supporting the teeth are destroyed. Teeth may become loose and may need to be removed. If you have periodontitis, your dentist can send you to a paradontitis specialist, an expert in the treatment of gum diseases.

Elevated blood sugar levels lead to more plaque and tartar

What are the most common mouth problems in people with diabetes?

The following diagram shows the most common oral problems in people with diabetes

Oral problemDescription of the conditionSymptomsTreatment
GingivitInflamed gingivitisDiscreet swelling and slightly bleeding gumsBrush teeth daily and use dental floss

Visit dental hygienist regularly to remove tartar
ParadontitParadontigivitis or other gum diseases, which varies from mild to severeReddened, swollen and bleeding gum

Prolonged infection between teeth and gum

Bad breath that doesn’t go away

Teeth that are permanently loose

Pus between the teeth and gums

Changes in the fit of prostheses, which are teeth that can be removed
Deep cleaning of pockets and between the teeth done by the dentist 

Surgery of the gums
Fungal infection of the oral cavity (oral candidiasis)Growth of a naturally occurring fungus that the body can not controlWhite or sometimes Red spots on your gums, tongue, cheeks or in the palateYour dentist may prescribe drugs that treat fungus in the oral cavity.
Dry mouth, called xerostomiaLack of saliva in the mouth, which increases the risk of caries and gum diseaseDry mouth

Pain or tingling in the mouth or tongue

Cracked lips,
cold sores or infection

Problems chewing, eating, swallowing or talking

Impaired taste
Taking medications that keep the oral cavity moist

Use chewing gum to produce more saliva

Drink water regularly
Avoid smoking, caffeine and alcoholic beverages
Burning sensation in the oral cavityA burning sensation in the mouth caused by uncontrolled blood sugar levelsBurning sensation in the mouth

Dry mouth

Bitter taste
See your doctor who may suggest a change in diabetes medication

As blood sugar levels decrease, the burning sensation in the oral cavity also improves

Other symptoms of mouth problems are as follows

  • Soreness, or a wound that does not heal
  • Dark spots or holes in the teeth
  • Pain in the mouth, face or jaw that does not yield
  • Loose teeth
  • Pain associated with chewing
  • Changed taste perception or a bad taste in the mouth
  • Bad breath that does not disappear when brushing your teeth

How do you know if your mouth problems are due to diabetes?

Check your mouth for signs of diabetes problems. If you notice any problems, contact your dentist directly. Some of the first signs of gum disease are swelling, soreness or bleeding gums. Sometimes you have no signs of gum disease. You may not know you have it until you have serious injuries. Your best defense is to see your dentist twice a year for cleaning and checking.

How does smoking affect my mouth?

Smoking aggravates the problems in the oral cavity. Smoking increases your chances of getting gum disease, oral and throat cancer and oral fungal infections. Smoking also discolors your teeth and makes your breath bad.

Smoking and diabetes are a dangerous mixture. Smoking increases the risk of many diabetes problems.

If you quit smoking happens the following

  • Reduces the risk of heart attack, stroke, nervous disease, kidney disease and amputation.
  • Your cholesterol and blood pressure levels may be improved.
  • Your blood circulation will improve
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