Relationship Between Diabetes and Periodontal Disease

Diabetes is a progressive systemic disease which brings along many surprising statistics. It is one of the most prevalent systemic disease involving millions of people worldwide. Diabetes is not limited to blood sugar and hormone levels; it can cause damage to eyes, nerves, kidney, heart, and oral tissues.

According to the Centers for Disease Control and Prevention, around 25.8 million people are affected by diabetes annually. Out of them, one-third of the people with diabetes suffer from severe periodontal disease. Periodontal disease is a deadly oral health issue which is caused by infection to the gum. Advanced stages of periodontal disease can involve the bone and teeth.


This oral condition worsens with the presence of diabetes. Periodontal disease in diabetic patients spreads rapidly and can eventually result in loss of one or more teeth. Let’s read further to understand the relationship between diabetes and periodontal disease. Moreover, we’ll look at some of the treatment options for periodontal disease.

What is a periodontal disease?

Periodontal disease is an inflammatory gum disease which develops slowly and affects the tissues surrounding the teeth. Commonly, plaque and bacteria in the mouth initiate the process of gum inflammation. In the early stages, the gums may appear red, swollen, and tender. Failure to remove the plaque and clean the teeth and gums may progress the disease. (1)

As more plaque forms near the gum line and under the gums, it hardens to become tartar. This stage is called Periodontitis. It causes the gums to pull away from the tooth surface and leads to the formation of loose pockets.

What is the relationship between diabetes and periodontal disease?

If you have diabetes, you must be aware of the risks of high blood sugar levels. Some of the risk factors may include damage to the kidneys, eyes, and heart. Additionally, diabetes tends to slow down the healing process of oral tissues. Furthermore, it compromises the resistance of oral tissues to infections, which increases the susceptibility to periodontal disease. (2) Some of the common contributing factors of diabetes that cause periodontal breakdown are as follows –

Diabetic control

Gum disease is directly linked to diabetic control – with poor blood sugar control; gum disease progresses to cause bone and tooth loss. Children with insulin-dependent diabetes mellitus also suffer from periodontal damage. (3)

Controlled diabetes reduces the risk of periodontal disease. However, the addition of oral health care routine is essential to eliminate gum disease.

Changes in blood vessel

Blood vessels are the prime source of oxygen and nourishment to the body tissues, including the mouth.  Diabetes often causes thickening of the blood vessels, which slows down the flow of nutrients and removal of harmful waste. (4)

Thickening of blood vessels weakens the resistance of gum and bone tissue to infection. It further complicates the gum disease and increases the risk of periodontal breakdown.

Changes in bacterial growth

Many bacteria thrive on sugars, mainly glucose. With uncontrolled diabetes, the glucose level increases in the mouth. Moreover, it encourages bacterial growth and initiates the process of gum disease.

What is the treatment for periodontal disease?

Professional dental treatment for periodontal disease mainly include two essential procedures –

Plaque control

Early stages of periodontal disease include deep cleaning and removal of plaque and tartar from the gums. This process helps to remove the bacteria and infection from the area under the gums. Additionally, it smoothens the damaged root surface of the teeth.

Deep cleaning and root planning allow the gums to re-attach to the tooth surface. A special antibiotic mouth rinse may also be prescribed to control the infection allow good oral hygiene.

Periodontal surgery

Gum surgery may be required during the advanced stages of periodontal disease. The affected area is first cleaned to remove the infection and reshaped or replaced by healthy tissue to support the bone and tooth.

How can you manage your oral health with diabetes?

If you have diabetes, an impeccable oral health care routine can help you to prevent periodontal disease and its harmful effects on the gums. Here are some of the essential steps you should follow to have a healthy mouth –

  • Check your blood sugar level regularly to keep your diabetes under control.
  • Inform your dentist about the recent blood sugar levels to plan necessary dental treatments.
  • Consult your physician before scheduling a treatment for periodontal disease. Let your doctor talk to your dentist and discuss the medical condition in detail.
  • If you are on insulin, change your meal schedule and timings accordingly. This is crucial, especially if you are planning to get periodontal surgery. (5)
  • If you have uncontrolled diabetes, postpone any non-emergency dental procedure. However, acute infections and abscesses should be treated immediately.
  • A person with diabetes may take more time to recover from periodontal surgery. However, with proper medical and oral care, healing can occur smoothly.

Take away message

Diabetes is a deadly systemic disease which affects many parts of the body, including the heart, kidney, and gums. Often, diabetic people ignore their oral health and focus on medical condition. However, it is essential to understand the disease and its risks on the oral tissues. Diabetes increases the risk of periodontal disease by increasing the blood sugar levels, which impair wound healing and thickening of blood vessels slow down the oxygen and nutrient flow to the gums.


Moreover, diabetes allows an increase in the bacterial growth, which causes damage to the gums. Progression of gum disease leads to bone loss and eventually, tooth loss. Nobody likes to lose their teeth unnecessarily. Visit your dentist for regular cleanings and plan other dental treatments accordingly.

Additionally, it is essential to maintain good oral healthcare routine – brush at least twice daily and floss once a day. Replace your toothbrush every three to four months. Include an antibacterial mouth rinse to increase gum healing and promote good oral hygiene. Develop a specific diet plan and include regular physical exercise to keep your diabetes under control. Stay up to date with your medical and oral health and live a happy, healthy life.


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