Diabetes: Keeping Your Mouth Healthy

Medically Reviewed by Michael Dansinger, MD on April 30, 2023
4 min read

If you have diabetes, you’re more likely to have oral health problems like cavities, and infections of the gums and bones that hold your teeth in place because diabetes can reduce the blood supply to the area.

If you have diabetes and you're over 50, your risk is even higher. Dental problems and age go hand-in-hand, whether or not you have diabetes.

You should call your dentist if you:

  • Have bleeding or sore gums
  • Get infections often
  • Have bad breath that won't go away

Controlling your diabetes will go a long way toward protecting your teeth and gums. And that, in turn, will also help you manage your diabetes.

If you have diabetes, keep an eye out for these oral health conditions -- especially if you've already reached the half-century mark.

Gum disease is the most common oral health problem among people with diabetes.

The first stage of gum disease is gingivitis. This is when bacteria cause your gums to bleed, turn red, and feel sore.

Bacteria love to feast on sugar, turning it into tooth-damaging acid. Uncontrolled diabetes means more sugar in your saliva, and that means a free banquet for bacteria.

As bacteria gather, they combine with saliva and pieces of leftover food to form plaque. When it builds up, it leads to tooth decay and gum disease.

Regular brushing and flossing, as well as rinsing with antiseptic mouthwash will get rid of it and stop gingivitis in its tracks.

If left untreated, gingivitis can turn into periodontitis, a more serious type of gum disease that erodes the bone and tissues that support your teeth. In the worst case, you might lose your teeth.

If you don’t floss and brush regularly, bacteria and plaque can build up on your teeth. That causes your gums to pull away from them. It creates pockets where bacteria dig in and wage war on more and more parts of your mouth, including bones.

Periodontitis can't be reversed and can't be treated with brushing and flossing alone. Your dentist will have to get involved. They may even send you to a specialist called a periodontist. Some people need gum surgery to save their teeth.

Both diabetes and older age (especially if you're a woman) slow down saliva production. This puts you at risk for dry mouth, which your doctor might call xerostomia.

Saliva makes the enzymes that attack bacteria. Without it, bacteria grow unchecked.

Dry mouth can lead not only to sores and ulcers but also to even more tooth decay and gum disease.

Bacteria aren't the only organisms that like sugar. So do fungi, which is why a fungal yeast infection called thrush is common in people with diabetes.

Thrush can cause white or red patches on your tongue and inside your cheeks. Sometimes they turn into open sores.

If you wear dentures, smoke, or take antibiotics, you may be even more likely to get thrush. The yeast thrives on the extra sugar in your saliva and especially likes moist spots like areas under loose-fitting dentures.

Thrush is just one kind of mouth infection diabetes puts you at risk for. There are others, including other fungal infections.

Both thrush and dry mouth can lead to burning mouth syndrome. So can certain medications, including some for high blood pressure.

In addition to feeling like you just scalded your mouth with coffee, your mouth could tingle or feel numb.

You might lose some of your ability to taste. This can also result from aging.

This isn’t really harmful, unless you make up for the lack of taste by adding sugar to your food. That will boost your risk of cavities and gum disease.

You may have noticed that wounds and infections take longer to heal. That’s a byproduct of both diabetes and getting older.

At the same time, your risk of infection goes up. That plus slower healing means that if something does go wrong with your gums or teeth, it’ll take longer to get better. And it might get worse faster.

This can also be a problem after dental surgery.

You’ll stop most tooth and gum disease before it has a chance to set in if you:

  • Keep your blood sugar in check.
  • Brush (use a toothbrush with soft bristles) and floss at least twice daily, and rinse with an antiseptic mouthwash.
  • Wait at least 30 minutes after eating before brushing to protect any tooth enamel that's been softened by acid in the food.
  • If you wear dentures, remove them and clean them daily. Don’t sleep in them.
  • If you smoke, quit.
  • Get a dental checkup every 6 months. Your dentist may recommend that you do it more often, depending upon your condition.

Let your dentist know that you have diabetes and what medicines you take. Let them know if your blood sugar level is off-track, and if you take insulin, tell them when you took your most recent dose.