Diabetes and Gum Disease


Dental disease is infectious. It can be transmitted through the sharing of utensils, toothbrushes and anything else that permits the exchange of saliva.

There is no “vaccine” for preventing dental disease.

Dental disease prevention requires active involvement of both the patient and a dentist. It includes regular examinations (with X-rays), diagnosis and treatment planning by a dentist, fluoride applications as needed, dental sealants and restorative treatment. Patient education, healthy dietary habits and daily oral hygiene practices are also important.


What is periodontal disease?

Severe periodontal (gum) disease often leads to tooth loss, but recent scientific research suggests a link to a variety of common, non-oral health conditions, including heart disease.

Our teeth are covered with a sticky film of bacteria called plaque. Brushing after meals and snacks and flossing between teeth daily helps remove plaque.

Plaque that is not removed may harden into calculus. When calculus accumulates either above or below the gumline, the gum tissue becomes irritated and inflamed. The early stage of periodontal (gum) disease is called gingivitis. Symptoms of periodontal disease include:

  • Persistent bad breath
  • Gums that bleed when teeth are brushed
  • Red, swollen and tender gums
  • Gums that have pulled away from the teeth
  • Loose or separating teeth
  • Pus between the gum and tooth
  • A change in one’s bite

Periodontal diseases are serious bacterial infections that destroy the attachment fibers and supporting bone that hold your teeth in your mouth. When this happens, gums separate from the teeth, forming pockets that fill with plaque and even more infection. The more advanced the disease, the deeper the pockets.


Diabetes and gum disease

While severe periodontal disease often leads to tooth loss, recent scientific research also suggests a strong link to a variety of common, non-oral health conditions, such as diabetes and heart disease.

Data from the Centers for Disease Control and Prevention’s 2011 National Diabetes Fact Sheet shows:

  • Diabetes affects 25.8 million children and adults in the United States or 8.3 percent of the population (diagnosed, undiagnosed and prediabetes).
  • The total economic cost (direct and indirect) associated with diagnosed diabetes in the United States in 2007 was $174 billion.
  • Diabetes makes it more difficult for a person to fight germs, including those germs found in the mouth.
  • Periodontal disease is more common in people with diabetes. Among young adults, those with diabetes have about twice the risk of those without diabetes.
  • Adults aged 45 years or older with poorly controlled diabetes were 2.9 times more likely to have severe periodontitis than those without diabetes. The likelihood was even greater (4.6 times) among smokers with poorly controlled diabetes.
  • About one-third of people with diabetes have severe periodontal disease consisting of loss of attachment of the gums to the teeth.

The American Academy of Periodontology surveyed more than 200 scientific English-language articles from the past 50 years that examined the relationship between periodontal disease and diabetes. This research review found:

  • Individuals with diabetes are three to four times more likely to develop chronic gum infections.
  • Inflamed gums may increase insulin resistance in a way similar to obesity, thereby aggravating glycemic or blood sugar control.

Gum disease, while more prevalent in adults, can start at any age. Children and teenagers who have Type 1 diabetes are at greater risk of developing gum disease than their peers. In a survey of 263 young people ages 11 to 18-years-old with Type I diabetes, 10 percent had obvious periodontitis.

Dentists believe such research findings support the idea that periodontal bacteria can easily enter the blood stream through open pores in inflamed gums and be transmitted to other parts of the body where it causes great harm.

Diabetes also can make an individual more susceptible to the following conditions:

  • Oral infections with symptoms including large or small areas of swelling; pus around teeth, gums or other areas in the mouth; persistent pain in the mouth or sinus area; white or red patches on gums, tongue, cheeks or the roof of the mouth; pain when chewing, particularly when eating something cold, hot or sweet; and teeth with dark spots or holes.
  • Fungal infections, such as thrush, can be aggravated by high blood sugar levels or frequent antibiotic use. Thrush appears as white (or sometimes red) patches in the mouth. Left untreated, it can become sore or turn into ulcers.
  • Poor healing increases the chances of infection after dental surgery. Controlling blood sugar before, during and after surgery helps with healing and minimizes complications.
  • Dry mouth, a condition also aggravated by taking certain medications. Germs and acids are more likely to accumulate due to reduced saliva, thus increasing the risk of cavities and salivary gland infections. Drinking more fluids, chewing sugar-free gum and sucking on sugar-free candy can help keep saliva flowing. Saliva substitutes also are available at some drug stores.


Keeping your gums healthy and managing your diabetes

Prevention is, and always will be, central to good oral health and is one of the best investments an individual can make.

Preventing dental disease is more than a one-time event. True prevention requires a comprehensive approach and includes:

  • Patient education
  • Observance of healthy dietary habits
  • Regular personal oral hygiene practices (Brush and floss daily!)
  • Consumption or application of appropriate fluoride supplements
  • Regular dental examinations with X-rays
  • Professional dental diagnosis
  • Appropriate placement of dental sealants
  • Necessary restorative treatment early in the development of dental disease

Dentistry has made great strides in prevention over the past decades, but development of dental infections and disease hinges on controllable (personal eating and hygiene habits, etc.) and uncontrollable (genetics and transmission of infectious bacteria) factors.

Dentistry is science based. The profession continues to advance independent clinical studies and research pertaining to prevention and oral health’s impact on overall good health.



Educate your patients about how periodontal disease can affect their diabetes and vice versa. Brochure material:

  • Defines periodontal disease and its symptoms
  • Discusses the link between periodontal disease and diabetes
  • Provides tips for maintaining healthy teeth and gums and managing diabetes

Visit The Dental Record’s website or call 800-243-4675 to place an order.