Dental Health and Diabetes: Why it Matters

There is a direct relationship between dental health and diabetes. Our mouths, including our teeth and gums, are affected by the changes that diabetes can cause in the body. There are some dental and oral health conditions that are considered to be complications of diabetes. Managing diabetes and maintaining healthy blood sugar levels can help reduce the risk of developing conditions that affect the mouth.^1,2,3 Along with the guidance of your doctor and dentist, understanding how diabetes impacts your mouth and ways to take care of your teeth and gums can help you incorporate oral care into your diabetes management routines.

What’s the connection between dental health and diabetes?

Diabetes affects how the body uses sugar, also known as glucose, for fuel. We get glucose from the foods we eat, including carbohydrates. Through digestion, the glucose in our food is broken down and makes its way into the bloodstream to be distributed to cells all over the body⁵. In both type 1 diabetes (T1D) and type 2 diabetes (T2D), the cells in the body are unable to effectively absorb the sugar in the blood.^6,7 This leads to high levels of sugar in the blood, which is called hyperglycemia.⁸

High blood sugar can have an impact on many parts of the body, including the mouth. The amount of sugar in the blood affects how much sugar is in saliva. High blood sugar means that there’s more sugar in the mouth. This sugar feeds bacteria that can cause cavities, tooth decay, and gum disease.² High glucose levels also damage white blood cells, which defend the body from infections and illness. Fewer white blood cells mean the body is less prepared to handle wounds and bacterial infections in the mouth, slowing down the healing process.³

Gum Disease and Diabetes

High blood sugar, along with the bacteria that thrives on sugar in the mouth, are linked to the development of gum disease, or periodontal disease. It is the most common oral health condition related to diabetes.1 Gum disease typically begins with inflamed gums and can advance over time. Gingivitis is the first stage of gum disease. It happens when plaque and tartar build up near the gumline, causing irritation that can lead to swelling and bleeding.¹ Periodontitis is the advanced stage of gum disease that involves bacterial infection of the gums and bone around the teeth. Untreated periodontitis leads to the teeth becoming so loose that they need to be removed.¹

Other Oral Health Conditions Related to High Glucose

High blood sugar levels can change the way the mouth keeps itself healthy. This includes regulating saliva production and the maintenance of the mouth’s microbiome—the community of both bad and good bacteria that help keep our body in balance.³ Just a few common oral health conditions that individuals living with diabetes are more likely to experience include:

• Dry mouth which is caused by hyperglycemia and may lead to infections, soreness, and ulcers such as canker sores.³
• Oral thrush, an overgrowth of yeast in the mouth, which is more common in those with high glucose levels or dry mouth and individuals who wear dentures.^3,13
• Burning mouth syndrome which can be caused by oral thrush or nerve damage due to elevated blood sugar levels, known as neuropathy.^8,14
• Loss of taste that can result from neuropathy in the mouth.⁸

Supporting Healthy Gums and Teeth when You’re Living with Diabetes

It’s a good idea to make oral health a part of your diabetes self-management routine. Maintaining healthy teeth and gums can help prevent infections and pain.² It can also help ensure your overall well-being as oral health conditions are linked to complications in other parts of the body, such as the heart and lungs.¹⁷

Managing your glucose levels is a major part of supporting healthy teeth and gums. Keeping your glucose levels within your target glucose range (generally defined by Diabetes Canada as 3.9–10.0 mmol/L ) as long as possible helps to keep your mouth healthy.¹⁹ Taking steps to avoid hyperglycemia over time can reduce the likelihood that you’ll experience uncomfortable oral health conditions and lower the risk of developing gum disease.¹

Be sure to talk to both your doctor and your dentist about the best ways to keep your mouth healthy. Here are a few steps you can take to care for your oral health on a regular basis as recommended by Diabetes Canada:²

• Schedule regular visits to the dentist for cleanings and check-ups at least every six months.
• Let your dentist know that you’re living with diabetes and which medications you are taking.
• Brush your teeth twice a day using a fluoride toothpaste.
• Floss your teeth at least once a day.
• Remove dentures for cleaning at least once a day.
• Maintain a healthy, balanced diet.
• Don’t smoke.

It’s important to ensure your dentist is informed about your medical history. During your appointments, they may need to know about the status of your glucose level management, such as whether you experience frequent low blood sugar and how recently you’ve injected insulin.³ Because high glucose can also impair the body’s ability to heal wounds, individuals living with diabetes must prioritize blood sugar management ahead of getting dental surgery.¹ Likewise, individuals with braces need to be mindful of whether wires and brackets are causing irritation or cuts in the mouth as they are more susceptible to infection.³

Take Care of Your Glucose Levels

Looking after your glucose levels plays a central role in managing diabetes. This can include lowering your A1C, which is the measurement of your average glucose levels over the previous three months.²¹ Diabetes Canada generally recommends that individuals living with diabetes aim for an A1C of ≤7.0% to reduce the risk of diabetes complications.¹¹ One of the ways to help lower A1C is to use a continuous glucose monitoring (CGM) system to keep an eye on your glucose levels. Using a Dexcom CGM system, including the Dexcom G7 CGM System, is proven to lower A1C and help you spend more time in your target glucose range.²⁰

Eating a balanced diet, engaging in a movement routine, getting enough sleep, and managing your stress levels are some additional ways you can lower your A1C and support healthy glucose levels. CGM systems such as Dexcom G7 can help you understand what affects your glucose levels on a day-to-day basis so you can take proactive action to get ahead of hyperglycemia and spend more time in range.

Everyone experiences diabetes differently and many complex factors can impact your glucose levels. It’s important to get tailored advice on how to control your glucose levels from your care team. With Dexcom G7, you can get your glucose readings right on your compatible smart device or pocket-sized receiver without the need for routine fingersticks.^{* †} Dexcom G7 can help give you better insight into what’s going on with your glucose levels, empowering you to make supportive treatment decisions with greater confidence.

• Learn how Dexcom G7 works

* For a list of compatible devices, please visit www.dexcom.com/compatibility.
† Routine fingersticks required for diabetes treatment decisions if symptoms or expectations do not match readings

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3 Oral Health Problems and Diabetes. Cleveland Clinic. Reviewed August 29, 2019. Accessed October 18, 2023. https://my.clevelandclinic.org/health/diseases/11263-oral-health-problems-and-diabetes.
4 Hantzidiamantis PJ, et al. Physiology, Glucose. StatPearls Publishing. Updated September 19, 2022. Accessed October 18, 2023. https://www.ncbi.nlm.nih.gov/books/NBK545201/.
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21 Lifestyle management. Diabetes Canada. Accessed October 18, 2023. https://diabetes.ca/about-diabetes/lifestyle-management.