Diabetes and Dental Care: Guide to a Healthy Mouth

What do brushing and flossing have to do with diabetes? Plenty. If you have diabetes, here's why dental care matters—and how to take care of your teeth and gums.

When you have diabetes, high blood sugar can take a toll on your entire body—including your teeth and gums. The good news? Prevention is in your hands. Learn what you're up against, and then take charge of your dental health.

Cavities and gum disease

Gingivitis can cause dusky red, swollen,
tender gums that bleed easily, especially
when you brush your teeth.

Whether you have type 1 diabetes or type 2 diabetes, managing your blood sugar level is key. The higher your blood sugar level, the higher your risk of:

  • Tooth decay (cavities). Your mouth naturally contains many types of bacteria. When starches and sugars in food and beverages interact with these bacteria, a sticky film known as plaque forms on your teeth. The acids in plaque attack the hard, outer surface of your teeth (enamel). This can lead to cavities. The higher your blood sugar level, the greater the supply of sugars and starches—and the more acid wearing away at your teeth.
  • Early gum disease (gingivitis). Diabetes reduces your ability to fight bacteria, which can cause more plaque to build up on your teeth. If you don't remove plaque with regular brushing and flossing, it'll harden under your gumline into a substance called tartar (calculus). The longer plaque and tartar remain on your teeth, the more they irritate the gingiva—the part of your gum around the base of your teeth. In time, your gums become swollen and bleed easily. This is gingivitis.
  • Advanced gum disease (periodontitis). Left untreated, gingivitis can lead to a more serious infection called periodontitis, which destroys the soft tissue and bone that support your teeth. Eventually, periodontitis causes your gums to pull away from your teeth and your teeth to loosen and even fall out. Periodontitis tends to be more severe among people who have diabetes because diabetes lowers the ability to resist infection and slows healing. An infection such as periodontitis may also cause your blood sugar level to rise, which makes your diabetes more difficult to control. Preventing and treating periodontitis can help improve blood sugar control.

Periodontitis is a severe gum infection that
can lead to tooth loss and other serious
health complications.

Proper dental care

To help prevent damage to your teeth and gums, take diabetes and dental care seriously:

  • Make a commitment to managing your diabetes. Monitor your blood sugar level, and follow your doctor's instructions for keeping your blood sugar level within your target range. The better you control your blood sugar level, the less likely you are to develop gingivitis and other dental problems.
  • Brush your teeth at least twice a day. Brush in the morning, at night and, ideally, after meals and snacks. Use a soft-bristled toothbrush and toothpaste that contains fluoride. Avoid vigorous or harsh scrubbing, which can irritate your gums. Consider using an electric toothbrush, especially if you have arthritis or other problems that make it difficult to brush well.
  • Floss your teeth at least once a day. Flossing helps remove plaque between your teeth and under your gumline. If you have trouble getting floss through your teeth, use the waxed variety. If it's hard to manipulate the floss, use a floss holder.
  • Schedule regular dental cleanings. Visit your dentist at least twice a year for professional cleanings. Remind your dentist that you have diabetes. To prevent low blood sugar during dental work, you might want to eat before your dental visits.
  • Take special precautions with dental surgery. If you're having dental surgery, make sure that your dentist consults with your doctor ahead of time. You may need to adjust your diabetes medications or take an antibiotic to prevent infection.
  • Look for early signs of gum disease. Report any signs of gum disease—including redness, swelling and bleeding gums—to your dentist. Also mention any other signs and symptoms such as dry mouth, loose teeth or mouth pain.
  • Don't smoke. Smoking increases the risk of serious diabetes complications, including gum disease. If you smoke, ask your doctor about options to help you quit.

Managing diabetes is a lifelong commitment, and that includes proper dental care. Your efforts will be rewarded with a lifetime of healthy teeth and gums.

By Mayo Clinic staff. Reprinted with permission from the MayoClinic.com article, “Diabetes and dental care: Guide to a healthy mouth,” accessed 4/26/12 at http://www.mayoclinic.com/health/diabetes/DA00013

Oral Health Grant Awarded to ADS

Aging and Disability Services (ADS) understands the importance of oral health and sees it as a key component in an individual's overall health and wellness, particularly for those individuals with acute and chronic diseases. We are grateful to be among five Area Agencies on Aging (AAAs) to receive a grant from Washington Dental Services Foundation to test and enhance their AAA Oral Health Toolkit. ADS will use these funds to develop and test training materials to increase oral health knowledge and skills for our staff, including case managers, RNs, and family caregiver specialists. Staff will also work with clients to increase their awareness about the importance of oral health and help them access dental services.