What is the link between diabetes and periodontal disease?

High blood sugar can increase the risk of developing gum disease. In turn, gum infections can raise blood sugar, which can make it harder to manage diabetes.

Periodontal disease, also known as gum disease, refers to conditions that affect the gums, which are the soft tissues in the mouth that support the teeth. People with diabetes are more likely to suffer from periodontal disease. However, by managing their blood sugar levels and maintaining their oral health, a person with diabetes can prevent gum disease.

In this article, we discuss the relationship between diabetes and periodontal disease and look at common gum conditions in people with diabetes.

The American Dental Association (ADA) notes that diabetes and periodontal disease have a two-way relationship. This means that while high blood sugar increases the risk of gum disease, gum disease makes it difficult to control blood sugar, potentially raising a person’s A1C levels.

For this reason, research has identified a link between periodontal disease and a higher risk of diabetes-related complications.

Diabetes can affect oral health by altering saliva. This fluid plays an important role in lubricating the mouth, removing debris, preventing bacterial growth, protecting tissues and fighting against bacterial acids and tooth decay. However, uncontrolled diabetes may cause the salivary glands to produce less saliva. This saliva may also contain more glucose.

These changes in saliva lead to dry mouth, which encourages bacteria to grow here and combine with food to form plaque. If a person does not remove plaque, it can build up on the teeth near the gum line and turn into tartar. This hard substance requires treatment by a dental professional to remove it. Without removal, tartar can lead to periodontal disease.

People with diabetes are more likely to have an intense inflammatory response to the bacteria. High blood sugar also interferes with wound healing and increases the risk of gum damage, which further increases the risk of infections and gum disease.

Thus, people who are unable to keep their blood sugar levels within a healthy range are more likely to experience oral symptoms. These can to understand:

Periodontal disease is the most common dental condition in people with diabetes. Some sources note that it affects almost 22% of people with diabetes. Other research also suggests that in the United States, almost a quarter of people over 50 with diabetes will experience severe tooth loss, compared to about 16% of people without diabetes.

Evidence indicates that people with type 2 diabetes are about three times more likely to develop dental problems than those without. People with type 1 diabetes also have an increased risk.

Gum disease is one of the most common and serious oral complications related to diabetes. Uncontrolled blood sugar increases the risk of mild to severe gum disease. Conditions a person may encounter to understand:


Gingivitis refers to inflammation of the gums and is often the first stage of gum disease. This condition develops when plaque and tartar build up on the teeth, near the gum line. This leads to irritation and inflammation of the gums, which can cause discomfort and lead to easy bleeding of the gums.


Periodontitis describes an infection of the gums and bones that support the teeth. It usually occurs as a result of untreated gingivitis. A person’s gums can pull away from the teeth, leaving small pockets. Bacteria can enter these pockets, form a gum abscess and begin to break down the gums and bones. Without treatment, this condition can lead to tooth loss.

Other possible dental problems related to diabetes include:

The ADA emphasizes the importance of practicing good oral care at home, attending regular dental appointments, and making lifestyle decisions that can benefit oral health.

General recommendations for maintaining good oral health include:

  • brush your teeth twice a day for about 2 minutes with fluoridated toothpaste
  • cleaning between teeth daily, using either dental floss, interdental brushes, oral irrigators, or wooden sticks
  • have a varied diet that limits drinks and snacks with added sugar
  • attend regular dental appointments to help prevent and treat oral disease

Lifestyle considerations may include:

  • drink water that contains fluoride
  • avoid smoking
  • avoiding oral piercings, such as tongue piercings

Additionally, the ADA stresses the importance of managing blood sugar for good oral health. Good blood sugar control can help prevent mouth infections and dry mouth. Tips to help manage blood sugar include taking medication, eating a nutritious, well-balanced diet, and exercising regularly.

Learn more about maintaining healthy gums.

People with diabetes are advised to visit a dentist regularly. The American Diabetes Association recommends that people attend dental appointments twice a year. If a person has diabetes, he should inform the dentist. They must also provide the dentist details about any diabetes-related problems, the medications they take and how long they have had diabetes.

If a person notices any oral symptoms, such as red and swollen or easily bleeding gums, they should contact a dentist as this could indicate gum disease.

People with diabetes have an increased risk of gum disease. Consistently high blood sugar levels can negatively affect oral health and increase the risk of infections that can lead to gum disease. Additionally, gum disease can make it harder to control blood sugar.

A person can reduce their risk of periodontal disease by keeping their blood sugar levels in a healthy range, brushing and flossing twice a day, and going to regular dental appointments.

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