People with diabetes are at a greater risk of developing periodontal (gum) disease and are slow healers. Dry mouth, a common symptom of undetected diabetes, can lead to ulcers, soreness, infections, and tooth decay. Smoking can worsen the situation.

Certain bacteria already exist in our oral cavity but their growth is kept under check by the body’s natural defense mechanism and saliva, which maintain a good oral hygiene. High glucose levels in the saliva of a diabetic patient facilitate the excessive growth of these bacteria. These bacteria, along with the food that is eaten, form a soft, colorless and sticky film known as plaque on the tooth surfaces. Certain types of plaque cause gum disease and bad breath, while others can cause tooth decay or teeth cavities.

The diabetic gum disease is severe and usually takes longer to heal. Moreover, serious gum disease can make it difficult to control blood glucose levels.

Oral Health Problems Associated with Diabetes

• Tooth Decay - The mouth naturally harbors various types of bacteria. When sugary foods or acidic beverages are consumed, these food substances interact with the bacteria present in our mouth to form plaque.

Uncontrolled diabetes increases saliva glucose levels and decreases the salivary secretion, thus providing increased sugar supply and enhancing bacterial growth for the formation of dental plaque which in turn increases the risk of dental caries in the mouth.

• Gingivitis - It is the initial stage of gum disease. Diabetes decreases the body’s ability to fight oral bacteria and keep them under control. If the bacterial plaque is not removed from tooth surfaces by brushing or flossing, it gets hardened to form tartar under the gum line and causes gum irritation. This leads to swollen bleeding gums, known as gingivitis.

• Periodontitis - It is an advanced stage of gum disease and is commonly observed in people with uncontrolled diabetes. If gingivitis is not treated on time, it results in damage to the soft tissue and bone that support the teeth. Eventually, periodontitis causes bad breath, bleeding gums, tooth mobility, and tooth loss. Periodontitis is a more serious condition among diabetics because diabetes decreases the body’s ability to fight infections and slows the healing process. On the other hand, an infection like periodontitis further increases blood sugar levels and makes diabetes difficult to control. Therefore, prevention and treatment of gum disease can help control the blood sugar levels.
• Oral Thrush - It is also known as oral candidiasis. It is a fungal infection of the oral cavity caused by an overgrowth of the fungus Candida albicans which gathers on the mucosal lining of the mouth. Candida is a normal inhabitant of the oral cavity but proliferates only in the absence of a good immune system. It often appears in the diabetic patients, including those wearing dentures. Oral thrush produces white or red patches in the oral cavity that are sore and may transform to ulcers inducing pain, taste impairment, and a burning sensation.

A high amount of sugar in the saliva, dry mouth, and a weakened immune system in diabetes make it one of the principal causes of oral thrush. Therefore, a good oral hygiene is important.

• Dry Mouth - It is also known as xerostomia, a term used to denote a condition in which the mouth is abnormally dry. Dry mouth mainly occurs due to high blood sugar levels in diabetics. Saliva flushes out germs and neutralizes acids in the mouth. A reduction in the amount of saliva encourages bacterial growth and occurrence of cavities.

• Taste Impairment - Diabetes affects the body’s immunity and predisposes to oral and perioral infections such as candidiasis, gingivitis, periodontitis and herpes simplex infections. These infections may alter the taste sensory system.

Tips for Healthy Mouth/ Dental Hygiene

• Go for regular dental checkups and periodontal screening.
• Keep a check on your blood glucose levels.
• Avoid smoking.
• Maintain oral hygiene by brushing twice a day with a soft-bristled toothbrush.
• Floss regularly.
• Use a fluoride toothpaste.

• Use mouthwashes.
• Watch out for any signs of oral diseases like bleeding gums, dry mouth, and oral pain.
• If you are using any type of dentures, clean them daily.
• Avoid dry mouth by drinking lots of liquids and chewing sugar-free gum to stimulate saliva production.