Guides · Gums
Diabetes and gum health: what people with diabetes need to know
The two-way relationship between diabetes and gum disease, the oral problems common in diabetes, precautions before treatment and how often to have check-ups.
Diabetes roughly triples the risk of gum disease (periodontitis) and slows healing. Conversely, untreated gum inflammation makes blood-sugar control harder. People with well-controlled diabetes can have dental treatment like anyone else; with uncontrolled diabetes, blood sugar is brought under control first. A periodontal check every 3–4 months is recommended.
A two-way relationship
High blood sugar lowers the gum tissue's resistance to bacteria, affects the small blood vessels and slows healing; gum inflammation progresses faster and destroys more bone in people with diabetes. Gum disease, in turn, is a source of chronic inflammation in the body; it increases insulin resistance and can raise HbA1c. Studies show that periodontal treatment lowers HbA1c by 0.3–0.4 points on average. Gum health is therefore seen as part of diabetes care.
Oral problems common in diabetes
- Gum disease: Bleeding, recession, mobility, tooth loss.
- Dry mouth: Less saliva means more decay and fungal infection.
- Fungal infection (candida): White patches and burning on the palate and under dentures; especially in denture wearers.
- Delayed wound healing: After extractions and surgery.
- Altered taste and a burning sensation
- Decay: Increases with dry mouth and frequent snacks.
Before dental treatment
- Tell your dentist about your diabetes, your medication and your latest HbA1c.
- Book a morning appointment after medication and breakfast; don't come on an empty stomach (risk of hypoglycaemia).
- Surgical procedures (extractions, implants, gum surgery) need controlled blood sugar; an HbA1c below 8 % is generally the target, and your dentist may consult your diabetes physician.
- Insulin users should say at once if they notice signs of hypoglycaemia (sweating, shaking, palpitations); sugar is kept in the clinic.
- Antibiotics and healing are followed more closely after surgery.
Can people with diabetes have implants?
Yes; with controlled diabetes the success rate is close to that of healthy individuals. With uncontrolled diabetes, osseointegration is delayed and the risk of peri-implantitis rises; blood sugar is controlled first. Combined with smoking the risk rises markedly. See Dental implants.
Home care
- Brush twice a day, clean between the teeth daily; pay attention to the gum margin
- For dry mouth: frequent sips of water, sugar-free gum, artificial saliva if needed; avoid alcohol-based mouthwashes
- Denture wearers should remove and clean the denture at night and brush the palate
- Stop smoking — diabetes and smoking together accelerate gum loss
- Bleeding, swelling, mobility or a wound that does not heal: a check-up without delay
How often to have check-ups
A periodontal check every 3–4 months, with cleaning if needed, is recommended for people with diabetes; those diagnosed with gum disease may be given shorter intervals. For treatment options see Gum treatment.
This article is for general information only; diagnosis and treatment tailored to you require a dental examination.
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