1 August 2017

Diabetes and Oral Health

Diabetes is Australia’s fastest growing chronic disease. Approximately 280 Australians develop the condition every day. In Western Australia, more than 112,000 people have been diagnosed with diabetes and for every person diagnosed, it is estimated that there is another person who is unaware they have the disease.

People living with diabetes are usually aware that the condition can affect their whole body including the eyes, nerves, kidneys, heart and other important body systems. But many may not know that diabetes can also cause complications in the mouth. Knowing which oral diseases can develop and how to minimise or even prevent them, is an important first step.

Why do people with diabetes have a higher risk of oral disease?

Oral disease in people with diabetes may occur due to one or more factors including poor blood glucose control, poor circulation (which reduces the body’s ability to heal) and certain medications. Smoking, sweet food and drinks will also increase the likelihood and severity of oral disease.

What are oral diseases?

People with diabetes, regardless of age, are prone to several oral diseases including tooth decay, fungal infections and gum disease (gingivitis and periodontal disease). In addition, people may also experience slow healing after extractions or oral surgery due to the thickening of blood vessels, which delays the delivery of nutrients to tissues.

Tooth decay

People with diabetes can also experience reduced saliva flow resulting in a dry mouth. A dry mouth encourages dental plaque to form on teeth which may lead to tooth decay. Untreated tooth decay can lead to toothache; tooth nerve infections, abscesses and possible tooth removal.

Fungal infections

Diabetes lowers the body’s resistance to infection, with people more likely to experience oral infections including fungal infections such as thrush. Oral thrush grows on the soft tissues within the mouth and may present as white bumps on the tongue, inner cheeks, tonsils and/or gums, along with redness and cracks at the corners of the mouth. Oral thrush may also cause difficulty in swallowing and may cause people to choose foods that are easier to eat, which may not be suitable for their diabetes.

Gum disease

Gum disease is caused by bacteria which produce toxins and create gum inflammation. Mild gum disease (gingivitis) may result in inflamed and/or bleeding gums and bad breath; while moderate to advanced gum disease (periodontal disease) may result in the presence of pus from the gums or loose teeth. People with diabetes may also feel changes in their bite or notice spaces developing between their teeth, sometimes encouraging food to stick between teeth. Most Australians will experience some level of gum disease, however it is usually more pronounced in people with diabetes.

Why is the management of gum disease especially important for people with diabetes?

Over the past 10 years, research has been conducted on the link between diabetes and periodontal disease. People with diabetes are three to four times more likely to develop periodontal disease.

The management of periodontal disease is extremely important for people with diabetes as research suggests the relationship between periodontal disease and diabetes is two way. Not only are people with diabetes more susceptible to periodontal disease, it also has the potential to affect blood glucose control and contribute to the progression of diabetes.

Oral disease can be prevented with a few healthy habits.

Oral Hygiene 

  • Brush twice daily with fluoridated toothpaste and a soft brush, removing all plaque on and between your teeth and at the gum line. Gently brush your tongue daily to remove bacteria to keep your mouth fresh and healthy.
  • Use dental floss or interdental cleaners daily to clean plaque from between your teeth.
  • People with dentures (full or partial) should remove them overnight and clean them daily.
  • Avoid a dry mouth by drinking plenty of fluoridated tap water and chewing sugar-free gum to stimulate saliva production. 
  • It is important to brush your teeth 30 minutes after eating sugary foods. If you can’t brush at that time, chew sugar-free gum to help stimulate saliva.
  • Visit your oral health professional regularly even if you wear dentures and book appointments for mornings when insulin levels are more stable.

Diabetes management

  • Keep blood glucose levels within target.
  • Take all medications prescribed by your family GP.  

Overall health

  • Quit smoking. Smokers with diabetes have an even greater chance of having severe gum problems than non-smokers and non-diabetics.
  • Follow a healthy diet.

Where to get help

Oral health

Diabetes management

  • Your family GP
  • Diabetes educator
  • Diabetes Information and Advice Line (DIAL) 1300 136 588

Quitting smoking

Dietary advice