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Diabetes and your oral health

Higher risk factors

Chances of dental decay or contracting periodontal diseases are higher in diabetic people.

These issues are added to other complications related to diabetes. They can affect your health, well-being and self-esteem. Moreover, a connection already exists between periodontal diseases, chronic gum infections, cardiovascular diseases, cerebrovascular accidents and respiratory afflictions.

Why are diabetic people more at risk?

In children

  • Glycemia is often harder to control in children. Hyperglycaemia can lead to dry mouth caused by a lesser production of saliva.
  • Recent research demonstrates that diabetic teenagers show more signs of gum inflammation and produce a higher amount of dental plaque.
  • For the dental decay process to begin, two factors come into play: dental plaque and carbohydrates.

Dental plaque + Carbohydrates = Acid

The tooth’s enamel in contact with the acid created will soften (demineralization). After you eat, saliva eliminates the acids located on the plaque and provides minerals to the soften tooth’s enamel to harden it (remineralization). As long as the demineralization and remineralization processes are balanced, decay does not happen.

In diabetic children, this balance is challenged by the drying of the mouth’s mucous membrane.

So, to prevent dental decay, two steps can be taken.

  1. Increase the tooth’s protection against acids.
  2. Reduce the amount of cariogenic bacteria.

Here is how it can be achieved:

Tooth brushing

Brushing performed correctly twice a day with toothpaste containing fluoride can eliminate dental plaque on your teeth.

Sometimes, using an electric toothbrush can help motivate the child and increase his or her dexterity.


The use of dental floss once a day is crucial to remove the dental plaque hidden between the teeth.

Children do not have the dexterity to correctly floss before 3rd grade. An adult must therefore help them on a daily basis.

Eating a slice of cheese

Chewing on a small slice of firm cheese immediately after consuming carbohydrates can help prevent dental decay.

  • It contributes to saliva production (protective effect).
  • It provides important minerals to the teeth (calcium and phosphorus).
  • It prevents the formation of strong acids present in the dental plaque’s bacteria.

Xylitol chewing gum

Chewing gum that contains xylitol two to three times a day for 5 to 10 minutes can help reduce the amount of bacteria causing decay in the dental plaque.

More great prevention methods:

  • Pit and fissure sealants;
  • Using mouthwash with fluoride;
  • Drinking acid liquids with a straw to reduce exposure to the teeth;
  • Rinse off acid drinks (fruit juice, soft drinks) with water to help protect the enamel.

Why do diabetes facilitate periodontal disease?

First, what is periodontal disease?

Periodontal disease is characterized by the destruction of the support (bone) around one or many teeth. Left untreated, bone damage can lead to tooth loss.

Periodontitis is mainly caused by the accumulation of tartar and dental plaque under the gum. The supporting structures gradually detach from the tooth, leaving a widening space between the tooth and the gum ending in the loosening of the tooth and receding of the gums.

  • Since a diabetic person is more likely to have accumulations of dental plaque due to a lesser saliva production that would eliminate said plaque, risks of periodontal diseases are higher.
  • However, the opposite is true for patients with uncontrolled diabetes.
  • A patient that has controlled diabetes has the same chances at successful periodontics treatment than a non-diabetic patient.
  • A type 2 diabetic patient is 2.8 times more likely to suffer from a periodontal disease and it climbs up to 3.5 times for type 1 patients.
  • Diabetes causes the inflammation of blood vessels, which reduces the influx of blood to the gums’ vessels, therefore affecting the gums’ nourishment and their healing ability.
  • A diabetic person tends to lose the collagen of their gums, accelerating the destruction process of the periodontium. Collagen is a protein contained in the supporting structures of the gums, skin, tendons and bones.
  • The liquid in the mouth of a diabetic person that has difficulties controlling their glycemia tends to contain more glucose, thus changing the nature of the dental plaque, favouring the formation of other types of organisms.

Prevention of periodontal disease

Naturally, one of the best ways to prevent and stop periodontal disease is to control one’s diabetes. Indeed, when it is controlled, gingival tissue acts almost normally.

However, when someone cannot control their diabetes, bone loss can be particularly severe.

Prevention and oral health

Like anyone else, a diabetic person must brush their teeth two to three times a day, floss once a day and use mouthwash that contains fluoride.

Moreover, they must undergo a dental exam and scaling treatment from their dental hygienist and dentist two to three times a year.

Other reasons to take care of your teeth

Diabetes can worsen periodontal disease and in turn affect the treatment of diabetes. Dental infection can exacerbate hyperglycaemia, have an impact on cardiovascular diseases and sometimes lead to acidosis. All of those afflictions make it hard to control glucose levels.

A diabetic person must have healthy eating habits to control their glycemia. If their gums are sensitive, their teeth are loose and chewing is painful, their dietary choices might suffer.

You should mostly remember that diabetes can affect oral health and oral health can affect diabetes. It also is of utmost importance to tell your dental hygienist or dentist of any changes in your medical situation. These professionals can advise you on the best solutions available.