Diabetes can affect your teeth and gums. So, keeping your mouth, teeth and gums healthy is an important part of managing your diabetes.
We’ll help you understand why you’re at risk and how to keep your mouth healthy.
This page covers:
- How diabetes causes mouth, gums and teeth problems
- Symptoms of mouth and teeth problems
- Gum disease
- Tooth decay
- Other mouth problems linked to diabetes
- Screening for mouth problems
- Reduce risk of dental problems
- Treatments for dental problems
- Find a dentist
How does diabetes cause problems with the mouth, gums and teeth?
Gum disease is the most common diabetes-related oral health problem.
Gum disease is inflammation of the gums. If gum disease affects the underlying bone then it is known as periodontitis. Gum disease is linked to a build-up of plaque on the teeth and gums.
Having diabetes can increase the risk of developing gum disease. And also, having gum disease can increase your blood sugar levels, which increases your risk of developing both prediabetes and type 2 diabetes.
Living with diabetes and some medicines used to treat diabetes mean that you make less saliva. Saliva helps protect your teeth and gums, so less saliva means you have a greater risk of tooth decay, and other mouth problems like tooth wear.
Diabetes can also increase the amount of sugar or glucose in your saliva, which can feed harmful bacteria that combine with food to form plaque. Plaque is a sticky substance that forms on your teeth, which is made from leftover food and saliva that are mixed in your mouth. Plaque contains bacteria, which can contribute to tooth decay and gum disease.
The good news is that in its early stages, plaque is soft and can be removed by effective cleaning between the teeth and good quality tooth brushing. Getting the right advice and support to stabilise gum disease can improve blood sugar levels in people with diabetes.
What are the symptoms of mouth and teeth problems?
In the early stages of gum disease, you may not be aware of it as it is usually painless.
The signs of dental problems are:
- bleeding gums
- shrinking gums
- bad breath
- loosening teeth
- new gaps between your teeth
- sensitivity to hot or cold drinks or food
- toothache
- tender gums
- pain when you chew.
If you notice these signs, don’t ignore them, make an appointment with your dental team.
Getting the right treatment early can prevent severe infections, tooth loss and other complications later.
Gum disease
Gum disease may appear as red, swollen and bleeding gums. If you have gum disease it can lead to receding gums, which is where gum around your teeth pulls back, exposing more of the tooth or gums that look puffy. If left untreated, early gum disease can get worse and lead to a loss of bone around your teeth.
You may hear your dentist refer to gum disease as gingivitis, which is when the inflammation only affects the gums, and this can be reversed.
It can also be called periodontitis where gum disease affects the gums and the underlying bone and can’t be reversed. Periodontitis can lead to tooth loss.
Tooth decay
Living with diabetes means that you are also at greater risk of developing tooth decay, also known as caries.
Too much sugar in your blood can lead to more sugar in your saliva, and that creates the perfect environment for bacteria to grow. The bacteria produce acid which attacks your teeth causing holes, also called cavities.
If you have hypoglycaemia, also known as low blood sugar or hypos, and use fizzy drinks or sweets to treat them, the sugar in those treatments can still affect your teeth. After treating a hypo, try rinsing your mouth with water or mouthwash or brushing your teeth after you have eaten something sugary. This is especially important at night, when your body naturally makes less saliva.
A chronic dry mouth is also a risk factor for tooth decay.
Other mouth problems linked to diabetes
You are more at risk of other problems such as:
- gum swelling also called gingivitis
- dry mouth also called xerostomia which increases your risk of tooth decay
- fungal infections also known as oral thrush. This can cause a white coating on your tongue or redness, soreness in your mouth and a change to your sense of taste
- irritated and sore mouth, meaning you might have difficulty wearing dentures
- tooth loss
- abscesses, which are caused by a bacterial infection that leads to pus collecting between the teeth, gums, and bone that holds the teeth in place.
What screening is there for mouth problems?
Dental checks are not part of the regular screening you can expect if you have diabetes. That’s why you should book your own regular check-ups with a dentist.
You should be asked about your gum and teeth health during your annual review and be reminded to go for dental check-ups.
Your dentist should tell you how often you should have check-ups depending on the assessment they make of your teeth and mouth.
How can I reduce my risk of dental problems?
Looking after your teeth and gums should be a basic part of how you manage your diabetes. You can prevent these potential complications by spotting them early and getting the right treatment from your dentist.
A big part of this is about regularly checking your blood sugars and trying to keep to your target blood sugar range.
Here’s what else you need to think about to protect your teeth and gums:
- Brush twice a day with fluoride toothpaste and after meals.
- If you have receding gums or gaps between your teeth use interspace or interdental brushes rather than floss to clean the gaps between your teeth. Ask your dentist to show you the best way to clean in between your teeth if you’re unsure. These videos made by the European Federation of Periodontology show you the best way to brush your teeth.
- You can also use products that help with dry mouth, such as gels, sprays, tablets or lozenges.
- Replace your toothbrush or toothbrush head regularly every 1-3 months.
- If you have dentures, do not wear them when you are asleep. Clean your dentures regularly as a build-up of fungus can lead to a type of thrush in the soft tissues under your denture.
- Book regular dental check-ups. Having diabetes doesn’t mean you get free dental treatment, but the NHS Low Income Scheme (LIS) means you could get help with dental costs if you are on a low income.
- Ask your dentist for your Basic Peridontal Examination scores and what they mean. This will help you to monitor your own gum health.
You can also reduce your risk of dental problems and gum disease by:
- Following a healthy, balanced diet which is low in sugar
- Being as active as possible.
- Not smoking or getting help to stop smoking. Smoking increases your risk of gum disease, weakens your immune system, making it harder for you to fight a gum infection and for your gums to heal.
The British Society of Periodontology and Implant Dentistry has helpful information and videos about preventing gum disease.
What treatments are there for dental problems?
If your problems are more serious you may need treatment from your dentist, such as cleaning under the gums, fillings in the teeth, removing teeth or gum surgery.
Ask your community pharmacist for advice about treating mouth problems. For example, if you have oral thrush or mouth ulcers, these could be treated with a special mouthwash or medication.
Talk to your diabetes healthcare team for more advice if you need it. Give our helpline a call if you’re worried about complications and need more support.
Find a dentist
Use these public service websites to find a dentist.
- Find a dentist in England - NHS website
- Find a dentist in Wales - Wales NHS website
- Find a dentist in Scotland - NHS Inform directory
- Find a dentist in Northern Ireland - NI Direct
