Diabetes and Oral Health – What’s the Connection?

Diabetes is one of the most common metabolic disorders, affecting the majority of the population in today’s times. Diabetes takes a toll on all your different body systems, including your oral cavity.

Diabetes affects the way your body processes sugar. High blood sugar levels make you more susceptible to oral health diseases. If left untreated, diabetes can cause some serious long-term complications.


If you have diabetes, it is vital that you monitor your blood sugar level regularly and keep a check on your daily diet.

As a person with diabetes, you should have full knowledge of your condition and how it can harm your body, especially your oral health. In this article, we will attempt to understand diabetes and its related complications in brief.

What is diabetes?

Diabetes mellitus, commonly known as diabetes, is a group of metabolic disorders characterized by high blood sugar levels over a prolonged period. It is characterized by frequent urination, increased thirst, and increased hunger.

There are three main types of diabetes –

  1. Type 1 diabetes mellitus– it results from the pancreas’ failure to produce enough insulin due to loss of beta cells. The cause is unknown.
  2. Type 2 diabetes mellitus– it begins with insulin resistance, a condition in which cells fail to respond to insulin appropriately. The most common cause is a combination of excessive body weight and insufficient exercise.
  3. Gestational diabetes– it occurs when pregnant women without a previous history of diabetes develop high blood sugar levels.

Signs and symptoms of Diabetes

The classic symptoms of untreated diabetes are unintended weight loss, increased urination, increased thirst, and increased hunger.

Symptoms develop rapidly in type 1 diabetes, while they usually develop slowly in type 2 diabetes.

Some other signs and symptoms of diabetes include –

  • Tiredness or fatigue
  • Blurred vision
  • Headache
  • Slow healing of cuts and bruises
  • Diabetic retinopathy (1)
  • Diabetic dermadromes

Low blood sugar in people with type 1 diabetes and type 2 diabetes can cause mild to severe effects, ranging from feelings of unease, sweating, and trembling.

Also, in mild cases, there is an increase in appetite. But there can be severe consequences, such as confusion, changes in behavior such as aggressiveness, seizures, unconsciousness and permanent brain damage or death in rare cases.

Causes of diabetes

The causes of diabetes can be classified into four categories –

  • Type 1 diabetes mellitus is caused by the loss of the insulin-producing beta cells of the pancreatic islets, leading to insulin deficiency.
  • Type 2 diabetes mellitus is characterized by insulin resistance, which may be combined with relatively reduced insulin secretion. It is primarily due to lifestyle factors and genetics.
  • Gestational diabetes involves a combination of relatively inadequate insulin secretion and responsiveness.
  • Some other causes of diabetes are –
    • Genetic defects of beta-cell function
      • Maturity-onset diabetes of the young
      • Mitochondrial DNA mutations
    • Genetic defects in insulin processing or insulin action
    • Defects in proinsulin conversion
    • Insulin gene mutations
    • Insulin receptor mutations
    • Exocrine pancreatic defects
    • Chronic pancreatitis
    • Pancreatectomy
    • Pancreatic neoplasia
    • Cystic fibrosis
    • Hemochromatosis
    • Fibrocalculous pancreatopathy
    • Endocrinopathies
    • Growth hormone excess
    • Cushing’s syndrome
    • Hyperthyroidism
    • Hypothyroidism
    • Pheochromocytoma
    • Glucagonoma
    • Drugs
    • Glucocorticoids
    • Thyroid hormone
    • Beta- adrenergics
    • statins
    • Infections
    • Cytomegalovirus infection
    • Coxsackievirus B

Complications of diabetes

All forms of diabetes have long-term complications. These complications are related to damage to the blood vessels. Some of these complications are as follows –

  • Coronary artery disease
  • Stroke
  • Peripheral artery disease
  • Diabetic retinopathy
  • Gradual vision loss
  • Glaucoma, cataract, and other eye problems
  • Diabetic nephropathy- tissue scarring, urine protein loss, etc.
  • Chronic kidney disease
  • Diabetic neuropathy- numbness, tingling, pain, and altered pain sensation
  • Diabetic foot ulcers
  • Painful muscle atrophy and weakness

Diabetes and oral health

Diabetes is a disease that affects the whole body, including your mouth. People with diabetes are at a higher risk of oral health problems. The link between diabetes and oral health diseases is high blood sugar.

The high blood sugar weakens white blood cells which impair the body’s ability to fight infections. The increased blood sugar levels in blood and saliva promote the growth of bacteria in the oral cavity.

The higher your blood sugar levels are, the higher you are at risk of the following conditions –

  • Tooth decayThe increased blood sugar levels in your blood and saliva provide a greater supply of sugar and starches for the bacteria in your mouth. This produces more acid in plaque, which can result in more cavities and decay.
  • Gingivitis and periodontitis Diabetes reduces your ability to fight infections. The bacteria present in the plaque start irritating the gums, leading to gingivitis. When gingivitis is left untreated, it can lead to periodontitis. Periodontitis is more severe in diabetics, as diabetes lowers the body’s ability to fight infections and heal wounds. It can cause the teeth to loosen and possibly, fall out.
  • Thrush – It is a fungal infection caused by yeast, Candida albicans. The fungus thrives on the high glucose levels in the saliva of people with uncontrollable diabetes. Signs of thrush include painful white or red patches inside your mouth.
  • Dry mouth (xerostomia) – People with diabetes can experience decreased salivary flow. It can cause dry mouth or xerostomia, which can expose you to more infections. (2)

Management of diabetes and oral health

Self-care and professional oral care from your dentist can help you maintain your oral health and also slow the progression of diabetes. You can follow these steps to help prevent damage to your teeth and gums – (3)

  • Monitor your blood sugar levels and follow your doctor’s instructions to keep your diabetes in check.
  • Brush your teeth at least twice a day. Avoid vigorous or harsh scrubbing which can irritate your gums.
  • Floss after every meal to help remove plaque between your teeth and gum line. Use a waxed dental floss to prevent injuring your gums.
  • Schedule regular dental visits for professional cleanings, X-rays and check-ups. Report any signs of gum diseases to your dentist.
  • Avoid smoking if you have diabetes. Smoking increases the risk of serious diabetic complications, including gum diseases and ultimately, loss of your teeth.


Diabetes affects a majority of the population today. Both young and old with new cases are being diagnosed every day.


Diabetes and oral health are closely related. Managing diabetes is a lifelong commitment, and that includes proper dental care.

Leading a healthy lifestyle that includes exercise, eating well and regular medical and dental care can help you manage diabetes for a lifetime.


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