The Impact Of Diabetes On Mouth Health

Being Diabetic can seriously limit and compromise your mouth health.

Research shows that if you suffer with Diabetes you have an increased prevalence to gum disease, because you seem to be more prone to severe periodontal disease. In fact, epidemiological studies have clearly identified that diabetes is a major risk factor for periodontitis, increasing your risk approximately 3x compared to non-Diabetics.

Evidence also shows that there is an important bi-directional relationship between periodontal disease and systemic disease in Diabetes.  Consequently, Diabetics with poor oral health are more at risk of developing organ failure and other systemic disorders such as Cardiovascular, Kidney Disease and Stroke.

This bi-directional relationship is called the seesaw effect; a phenomenon regularly found in Diabetes, as indicated in the diagram below:

The severity of periodontal disease in Diabetics may be partly due to compromised immune responses which slow down healing and in turn lead to chronic inflammation and infection in the mouth. However, the increased risk of periodontal disease in Diabetes is also linked to Diabetic medication as well as the condition known as Xerostomia (Dry Mouth) which can also accompany Diabetes. This latter problem is particularly prevalent during the night which may contribute to the accumulation of glucose in your mouth during sleep.

So, even though you control your blood glucose levels and maintain a healthy diet, as a Diabetic you can have up to 4 times more glucose in your saliva than non-Diabetics.  This may be one of the factors which cause Diabetics to experience progressive periodontal problems.

On the positive side, evidence shows that controlling periodontal problems in Diabetes can also help to control your blood glucose levels.

Unfortunately, many Diabetics are unaware of the links between periodontitis and Diabetes and of the potential benefits that periodontal treatment can have in controlling your Diabetes.

Dry mouth (also known as Xerostomia)

This is a recognised side-effect of diabetes and can worsen as diabetes goes on. It is probably brought on by medication but may also be due to a change in your immune system.

Having dry mouth means that you have less saliva, but this doesn’t mean you are any less exposed to excess salivary glucose.

Moreover, because your saliva contains important antimicrobial mechanisms to help protect your teeth and gums, having dry mouth also means you have less natural protection in your mouth which, in turn, leads to increased levels of decay and gum disease, in addition to the difficulties associated with excess salivary glucose.

Oral thrush

Oral Thrush is a fungal mouth infection and is common in diabetics. You can recognise Thrush from white (or sometimes red) patches in the mouth and on the tongue. These patches can become painful and turn into ulcers.

They are particularly uncomfortable and problematic if you wear a denture.