Diabetes and Oral Health

By Dr. Eli Prenzlau 

People might wonder what diabetes has to do with dental issues, but it’s really quite simple: If you are a person with diabetes, high blood sugar can affect your entire body — including your teeth and gums. In both types of diabetes, type 1 or type two, managing the sugar levels is the key to controlling related dental issues. If you have diabetes, you’re at a higher risk of experiencing oral health problems, such as gum disease, dry mouth, cavities and thrush. This risk is due to changes in blood glucose levels, medications taken for diabetes, and the overall response to infection associated with diabetes. Therefore, you should make sure that you see your dentist on a regular basis to rule out any complications. 

Gum Disease 

Gingivitis—inflammation of the gums—occurs more often, and may worsen in people with diabetes. Researchers are even suggesting that gum disease may make it harder for people with diabetes to control their blood glucose levels. A person with diabetes is highly prone to develop gum disease and swollen tender gums that easily bleed. 

People with diabetes are more prone to gum disease because their bodies don’t respond to infection the same way as non-diabetics. Swelling is greater, and damage to the gums and jaw bone is increased. Plaque can harden under your gum line into a substance known as tartar (dental calculus). This needs to be removed on a consistent basis (with thorough brushing twice daily and flossing once a day). If it is left to build up around the gum line, the resulting irritation at the earlier stages is known as gingivitis. If the tartar continues to build up and remains untreated, it will lead to a more serious and advanced gum condition, known as periodontitis, ultimately destroying the soft tissue and bone that supports the teeth. Eventually, periodontitis can cause the gums and jawbone to pull away from the teeth, leading to loosening teeth, which may 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 in turn makes your diabetes more difficult to control. Preventing and treating periodontitis with regular dental cleanings can help improve blood sugar control.  

Dry Mouth and Cavities 

Many people with diabetes experience a condition involving a lack of saliva, known as “dry mouth”, or xerostomia. This may be due to the diabetes itself, as well as to the medications that people with diabetes take. In addition to being uncomfortable, dry mouth can cause bad breath, sore tongue or throat, and difficulty chewing, speaking or swallowing. 

Sufficient amounts of saliva are needed in order to keep the mouth moist and bathe the teeth. Without this, you could be at risk of tooth decay, gum disease and thrush.  

If you have diabetes, this condition can cause cavities to form even under fillings you already have. Good oral hygiene is a must! Your dentist may also recommend a fluoride rinse to help strengthen your teeth and prevent cavities that dry mouth can cause. 


People with diabetes are at greater risk of getting thrush, a type of fungal infection, caused by the yeast Candida albicans. What does thrush look like? It appears as white or red patches on your tongue and the insides of your cheek. It can be painful and may cause a burning sensation. Antifungal medications can help alleviate thrush, and your dentist can recommend one, depending on the severity of the condition. Practicing good oral hygiene can help you avoid thrush. 

In conclusion, diabetes can affect your mouth in different ways. Following these simple rules will keep your mouth healthy and infection free: 

  1. Commit to good management of blood glucose levels, monitoring them regularly, with the goal of keeping them within your target levels.  
  2. Brush your teeth twice a day (morning and night, and after snacks and meals, when possible) with fluoride toothpaste. Use a soft-bristled toothbrush and be careful to avoid harsh brushing, or irritating the gums. An electric toothbrush also works well. Remember to replace your toothbrush frequently. 
  3. Use floss or other interdental cleaners once a day. This helps to clean the gum line. If it’s difficult to get between the teeth, used a waxed variety, or even floss holders to help with gripping the floss. 
  4. Watch out for the signs mentioned above: loose teeth, redness, swelling and bleeding gums, dry mouth, or mouth pain. Make sure to mention these to your dentist at your next appointment. 
  5. Avoid smoking, because it can increase the risk of serious diabetes complications, including gum disease and eventually, the loss of teeth.  
  6. See your dentist regularly! Schedule appointments for checkups, cleanings and x-rays.  Make sure to tell him about your diabetes at each visit and mention which medications you are taking. 

Managing diabetes needs to be a serious and life-long commitment. Proper dental care is part of this. If you are diligent about caring for your teeth, hopefully you will continue to experience healthy teeth and gums for the rest of your life! 


Dr. Prenzlau’s Oral Health Center in Jerusalem offers the full range of dental and oral health treatments, including oral rehabilitation, implants and esthetic dentistry. They are located on Rechov Azza 26 in Jerusalem and can be contacted at 02-566-0669 

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