Diabetes is a serious health condition that can affect the entire body. Complications from diabetes can occur inside the mouth. They can impact your quality of life every day. The mouth is often overlooked as an area of the body that can have complications associated with diabetes.
Types of complications
Diabetes can lead to multiple complications in the mouth. These complications can be more severe if you have poor control of your blood glucose levels. If you have diabetic neuropathy, you may be more likely to develop complications in your mouth also.
The best-known complication is severe gum disease, called periodontitis.
Other complications can include:
- tooth decay.
- a decrease in saliva causing a dry mouth
- oral thrush.
- delayed or poor healing of wounds in the mouth, such as mouth ulcers
- a change in taste.
Periodontitis is a chronic disease that requires life-long care and treatment. It causes damage to the bones and gums that hold the teeth in place. The gums and bone can wear away making the teeth look longer. These changes are permanent.
Signs of periodontitis can include:
- bleeding gums
- bad breath
- sensitive teeth
- loose teeth
- gums pulling back from the teeth
- teeth look longer than they used to
- gaps developing between the teeth causing food to get stuck
Severe periodontitis that is not treated can cause your teeth to become loose, cause pain and you can even lose your teeth.
If you have diabetes, you have a greater risk of developing periodontitis, particularly if your blood glucose levels are not within the recommended range of 4-7 mmol/L. If you have good management of your blood glucose levels, your risk of developing periodontitis is the same as someone who does not have diabetes.
There is scientific evidence that shows a two-way relationship between periodontitis and diabetes. Periodontitis may negatively affect blood glucose levels. People with periodontitis have a higher chance of developing prediabetes and diabetes. People with periodontitis have poorer glycaemic status (higher level of HbA1C) compared to people without periodontitis.
Treatment of periodontitis has shown to create a mild improvement in blood glucose levels. However, these results only lasted for three months. Researchers are doing longer term studies to find out more.
These relationships can be different for people with type 1 diabetes compared to type 2. If you have diabetes, it is important to control both your oral health and diabetes.
Tooth roots hold the teeth in the mouth. They are usually covered by bone and gums. Periodontitis can cause the bone and gum around the tooth to wear away. This can uncover the root surface which is not as strong as the tooth crown.
Tooth decay can develop on the surface of tooth roots more often if you have diabetes. This decay is influenced by factors associated with diabetes:
- gums wear away due to periodontitis exposing the surfaces of tooth roots
- a decrease in the amount of saliva made.
Saliva helps to protect teeth against decay. If you have less saliva, you have a higher risk of developing tooth decay.
You may have a greater risk of making less saliva causing a dry feeling in your mouth. This is reported as more common if you already have complications such as diabetic neuropathy.
Oral thrush is a fungal infection that can occur in and around the mouth and throat. It is also called oral candidiasis. It is mostly caused by an overgrowth of fungal yeast called candida albicans.
Symptoms of oral thrush can include white patches in the mouth. The white patch can often be wiped off and will leave behind red areas that may bleed slightly. It can affect diabetics due to multiple reasons:
- a poor immune system
- a decrease in saliva being produced
- high blood glucose levels causing increased glucose in saliva which can cause the fungal infection to live and grow.
Changes in blood flow and a poorer immune system can cause wounds in the mouth to heal slower.
The ability to taste foods and drinks can be affected in people with diabetes. The underlying cause for this is not clear. It may be related to the taste receptors in the mouth renewing at a slower rate or is suggested to be associated with the presence of diabetic neuropathies.
Caring for your oral health
Key steps to look after the health of your teeth and gums and to decrease your risk of diabetes complications include:
- brush your teeth twice a day using a soft toothbrush with a pea-size amount of fluoride toothpaste
- clean between your teeth every day
- eat a low sugar diet
- drink fluoridated tap water
- chewing sugar-free gum to help create saliva
See your dentist regularly
Your dentist will let you know how often to return for a routine check-up. You may need to see your dentist more often if you have complications in your mouth from diabetes.
It is important to tell your dentist if you have diabetes and how well your condition is controlled. Tell your dentist the names of all medication you take including prescribed and over-the-counter medicines.
Avoid smoking
Other than diabetes, cigarette smoking is another key risk factor for developing periodontitis. Tell your dentist if you are a current or past smoker.
Protect your teeth from sugars
After having fast acting carbohydrates, such as jellybeans, soft drink, fruit juice or sugar directly, it is important to also drink water. This helps to rinse sugar and acids from your mouth. If you are going to brush your teeth, try to wait 60 minutes before you do.
More information
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