Diabetes and Oral Health

One in three Canadians has diabetes or prediabetes.
You may know of the relationship between poor oral health and bad breath, cavities or even heart disease, but did you know that poor oral health can affect how well you control your diabetes? Diabetes can even increase your risk of developing certain oral health conditions.

About diabetes

Diabetes is a disease that prevents your body from producing insulin or from properly using the insulin it produces. Insulin is a hormone that helps your body regulate the amount of glucose (sugar) in your blood.

There are four types of diabetes:

Prediabetes

Diagnosed when an individual’s blood sugar levels are higher than normal, but not high enough to be considered Type 2. When prediabetes isn’t managed, it can lead to Type 2 diabetes.

Type 1

Usually diagnosed in children and adolescents; occurs when the body cannot produce its own insulin.

Type 2

Usually develops in adulthood; occurs when the body cannot use the insulin it produces effectively. It can be managed through a combination of medication and lifestyle changes.

Gestational

Occurs during the second or third trimester of pregnancy; usually disappears once the baby is born but carries an increased risk of developing Type 2 for both mother and child.

Signs and symptoms of diabetes include:

Thirst icon — Increased thirst and frequent urination

Weight loss icon — Unexplained weight loss

Slow healing sores icon — Slow healing sores

Risks to oral and overall health

Diabetes affects your health in many ways, including increasing your risk for heart disease and stroke, kidney disease, glaucoma, and cataracts, as well as lengthening the time it takes for wounds to heal. When poorly controlled, diabetes also increases your risk of developing the following oral conditions.

Gum disease (periodontal disease): inflammation and infection of the gums and bone that surround and support the teeth. Initially, gums may be sore or bleed when teeth are brushed. Over time, bone loss resulting in tooth loss may occur. Untreated gum disease can also cause blood sugar to rise, making it harder to control diabetes.
Dry mouth (xerostomia): occurs when the glands in the mouth don’t produce enough saliva. Common in people with high blood sugar, dry mouth increases plaque levels on the teeth, raising the risk of cavities.
Oral thrush: a fungal infection caused by high sugar levels in the saliva.
Sensation of burning in the mouth or on the tongue.

Oral health care tips

If you have diabetes, regular appointments with your dental hygienist can help you manage your blood glucose levels and maintain good oral health. There are also many things you can do at home to improve your oral health.

Monitor and control your blood glucose.
Brush twice daily, using a soft toothbrush or power toothbrush and a fluoridated toothpaste, and clean in between your teeth daily.
Follow a healthy diet that limits sugars, and drink water throughout the day.
Quit smoking. Your physician or dental hygienist can offer smoking cessation strategies.
Chew sugar-free gum or suck on sugar-free hard mints, such as those containing xylitol.

Tips for your dental hygiene appointment

To get the most out of your dental hygiene appointment, remember to:

Inform your dental hygienist that you have diabetes.
Schedule your appointment in the morning or when your glucose levels are highest.
Know your glycated hemoglobin (HbA1c) level. Your dental hygienist needs to know if your diabetes is under control when performing oral health assessments. If you are self-monitoring at home using a glucose meter, the value should be between 4 mmol/L and 8 mmol/L.
Bring a list (names and dosages) of all medications you are taking.
Tell your dental hygienist the time of your last dose of insulin, medication or last meal.
If you have dentures, inform your dental hygienist of any changes to their fit, as well as any pain or sores on your gums.

Dental hygienists have the skills and training to identify signs and symptoms of undiagnosed or uncontrolled diabetes. They will refer you to your doctor for a medical consultation and will work with you to ensure that you enjoy optimal oral health at all times.