Is Diabetes Affecting Your Mouth? Symptoms and Treatments

Here's one more reason to maintain good blood sugar control: it helps keep your pearly whites healthy. When your blood sugar is high, the chances of getting gum disease are significantly higher, too. Diabetics in poor control have a higher than average chance of getting gingivitis, the start of gum disease. If this progresses, periodontitis, the more severe form of gum disease, is the result.

In this health disorder, the gums actually start to recede from the teeth, causing pockets to form between the gums and the teeth. Unchecked, periodontitis eventually requires surgery to save the teeth. If this doesn't help and infection sets in, the bone around the teeth could be destroyed. In this case, a typical outcome involves extracting the teeth. Obviously, this is the very last resort, and it's much better to keep on top of your blood sugar so you don't experience gum disease in the first place.

Gum disease and poorly controlled diabetes are a two-way street, explains Robin Goland, MD, director of the Naomi Berrie Diabetes Center at New York-Presbyterian Hospital/Columbia University Medical Center in New York City.

"If you have gum disease, with all the elements of infection and inflammation, this worsens your diabetes control," she explains. "This is because any infection causes insulin resistance and high blood sugar." By keeping one condition in check, you're actually helping the other condition, she says.

But periodontitis isn't the only mouth condition diabetics must be aware of.  An oral infection is another potential worry, so be on the alert for symptoms such as pain when chewing or red or white patches on your gums, tongue or the roof of your mouth.

Thrush is one infection that may occur: it's a fungal infection that presents with patchy white or red areas in the mouth that become sore. It's treated with an anti-fungal medication, and patients are encouraged to get their blood sugar back in control.  

Another condition, dry mouth, is extremely annoying, and like gum disease, more common in those whose diabetes is in poor control.

"When your blood sugar is high, you have dry mouth,'" says Spyros Mezitis, MD, endocrinologist at Lenox Hill Hospital in New York City. "But by controlling the diabetes, you can control dry mouth."

Not only is dry mouth uncomfortable, but it can increase your risk of tooth decay because there's not as much saliva in the mouth to wash away germs. Sometimes having a dry mouth can contribute to other health problems, too, such as salivary gland infections.

Often, if a non-diabetic shows up at the doctor with problems like thrush and periodontitis, he or she will be screened for diabetes. In fact, mouth problems often alert health care providers to check for the presence of diabetes, Mezitis explains.

Preventatitve Measures

The best thing you can do for your teeth is to maintain good blood sugar control. And here are eight more ways to keep your smile bright.

● Visit the dentist at least every six months (and more often if recommended by your dentist). The early signs of gum disease are silent, so the only way to know if you have it is through your dentist.

● Be sure your dentist knows you have diabetes.

● Brush with a toothpaste prepared with antigingival/antibacterial ingredients, to help prevent gingivitis.

● Brush at least twice a day and for two minutes each time.

● Use dental floss every day, being sure to use it correctly. That means slicing the floss up and down and then curving it around the base of each and every tooth. Start with an 18-inch length of floss, and always use a clean section of the floss as you proceed from one tooth to the next.


If your gums are bleeding or are red, puffy or swollen, see your dentist immediately.

If you have a bad taste in your mouth or always have bad breath, see your dentist.

If you have dry mouth, try drinking more fluids, chewing sugar-free gum or sugar-free candy to promote saliva flow, or picking up some saliva substitutes at your pharmacy.


Living with Diabetes: Diabetes and Oral Health Problems. The American Diabetes Association.

Living with Diabetes: More on the Mouth. From the American Diabetes Association.