The Link between Diabetes and Oral Health Problems

You may not think diabetes affects oral health. However, research suggests that people with diabetes are at higher risk for oral health problems. Mouth and gum problems develop when diabetes is not effectively managed. 

High blood sugar can make it more difficult to keep your mouth healthy. It can weaken white blood cells, which provide protection against bacterial infections, including those that occur in your mouth. This can lead to cavities and gum disease. 

Also, when you have diabetes, your body tends to make less saliva, which protects your mouth against dryness. Lack of saliva from dry mouth means food debris, sugar, acid, and bacteria do not get washed away as easily. Diabetes can also increase the amount of glucose in your saliva, leading to more bacterial growth and plaque build-up.

Over time, gum disease can develop from high blood glucose levels. Gum disease is an infection and inflammation of the tissues that support your teeth. Without treatment, gum disease can destroy the bone that supports your teeth. Gum disease can be more severe and take longer to heal if you have diabetes, says the CDC. And if you have gum disease, your diabetes may be harder to manage.

Diabetes oral health complications

• Dry mouth

• Gingivitis (early-stage gum disease)

• Periodontitis (advanced gum disease)

• Thrush

• Burning mouth and/or tongue

Dry mouth: Dry mouth results from a decrease in saliva, which can lead to soreness, ulcers, infection, and tooth decay. It can increase the risk of cavities because there is less saliva to wash away germs, which create acids. According to the American Diabetes Association (ADA), dry mouth may be caused by medications or if blood glucose levels are too high. Besides drinking more water, managing your diabetes can help prevent or relieve this diabetes oral health problem. 

Gingivitis: Gingivitis is the earliest stage of gum disease. It develops when plaque, tartar and bacteria build up on the teeth causing infection leading to irritation, swelling, and bleeding of the gums. 

Periodontitis: Periodontitis is an advanced gum disease. It is a bacterial infection causing gums to bleed and swell and can be the result of high glucose levels, which make it harder to fight bacteria in your gums. Left untreated, the infection destroys the bone around the teeth, causing your teeth to start to move or become loose. Conversely, gum disease, like all infections, may cause an increase in blood glucose, making it harder to manage your diabetes and in turn harder for your body to fight the infection. 

Thrush: Another one of the diabetes oral health problems is thrush, which is an infection of the mouth and tongue. It is caused by fungus growing in your mouth. Having diabetes and frequently taking antibiotics to fight various infections increases the chances of getting thrush. The fungus thrives on high glucose levels in the saliva of people with unmanaged diabetes.

Burning mouth and/or tongue: Caused by thrush.

Watch for these warning signs

The following area warning signs of diabetes oral health problems, notes the ADA:

• Gums bleed when you brush or floss. 

• Red, swollen, or tender gums. 

• Gums that have pulled away from teeth. Part of the tooth’s root may show, or your teeth may look longer. 

• Pus between the teeth and gums. 

• Bad breath. 

• Teeth that are loose or moving away from each other. 

• Changes in the way your teeth fit when you bite. 

• Changes in the fit of partial dentures or bridges. 

Prevent diabetes oral health complications 

When it comes to oral health as well as any other health complications from diabetes, prevention is key. Start by letting your dentist and hygienist know you have diabetes and about any changes to your teeth or gums and any medications you are taking. You also want to: 

1. Manage your blood sugar, trying to keep it as close to normal as possible. For instance, know your glycosylated hemoglobin (HgA1C) level. A level under 7 percent indicates good management.
2. Visit your dentist at least twice a year for regular checkups and cleaning. Studies show that treating gum disease can help improve blood sugar control if you have diabetes, decreasing the progression of the condition. Practicing good oral hygiene and having regular professional cleanings can help lower your A1C.
3. See your doctor before scheduling treatment for periodontal disease. If oral surgery is necessary, your doctor should talk to your dentist or periodontist about your overall health condition. You may need to take pre-surgical antibiotics, change your insulin dosage, or adjust your meal schedule prior to surgery.
4. Postpone any non-emergency dental procedures if you are having trouble reaching your blood glucose targets. If, however, you have an acute infection, treat it right away.

Oral hygiene tips for diabetes

To prevent diabetes oral health problems, follow these daily tips from the CDC:

• Brush your teeth at least twice a day with fluoride toothpaste.

• Floss your teeth at least once a day.

• If your gums are red, swollen, or bleed easily, see your dentist. These may be signs of gum disease.

• If you smoke, take steps to quit. Smoking increases your risk of gum disease and can worsen your diabetes.

Managing your diabetes and practicing good oral hygiene can reduce the risk of mouth and gum problems, which can in turn affect your diabetes. 

1 “Diabetes and Oral Health,” American Diabetes Association Diabetes Advisor, Accessed April 29, 2025, https://professional.diabetes.org/sites/dpro/files/2024-01/sci-advisor_2021_diabetes_oral_health_11_17.pdf

2 “Diabetes and Gum Disease,” American Diabetes Association, Accessed April 29, 2025. https://diabetes.org/about-diabetes/complications/oral-gum-disease

3 “Oral Health and Diabetes,” CDC, Accessed April 29, 2025. https://www.cdc.gov/diabetes/diabetes-complications/diabetes-and-oral-health.html