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FACT: Diabetics have a higher-than-normal risk for gum (periodontal) problems.
Poor blood glucose control makes gum problems more likely. We want to share with you some important information so you can make better-informed decisions when it comes to your diabetes and your oral health.

Diabetes and Periodontal (Gum) Disease: Controlling blood sugar levels is important
Good diabetic control is the best protection against gum (periodontal) disease. People with poor blood sugar control get gum disease more often and more severely than people in good control of their blood sugar levels.

How Does Periodontal Disease Develop?
Gum disease is an infection of the tissues that hold the teeth in place. There are often no warning signs of early gum disease. Symptoms such as pain, abscess and loosening of the teeth do not occur until the disease is in its advanced stages. Plaque builds and hardens under the gums, causing the gums to become inflamed. The infection may lead to loss of the bone around the teeth and can lead to tooth loss.

What Are the Warning Signs?
Gum disease is often painless; Plan a visit to your dentist if you have any of the following warning signs:

• Bleeding gums when you brush or floss


• Red, swollen or tender gums


• Gums that have pulled away from teeth


• Pus between the teeth and gums


• Bad breath


• Permanent 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

What Treatment Is Available?
Gum disease may be treated by deep cleaning to remove the hardened plaque below the gum line. Gum surgery may be needed when gum disease is very advanced. Treatment is successful only if the patient regularly brushes and flosses to keep the plaque from building up again.

What Other Mouth Problems May Diabetics Experience?
Oral infections: An oral infection is a cluster of germs that invades an area of your mouth. Some of the warning signs of an oral infection are:

• Swelling or pus around your teeth or gums or any place in your mouth. Swelling can be large or small.


• Pain in the mouth or sinus area that doesn't go away.


• White or red patches on your gums, tongue, cheeks or the roof of your mouth.


• Pain when chewing.


• Teeth that hurt when you eat something hot or cold or when you chew.


• Dark spots or holes on your teeth.

Fungal infections: Infections can make your blood glucose hard to control. When you have diabetes you are more prone to fungal infections, such as thrush, because the fungus thrives on high glucose levels in saliva. Smoking and wearing dentures can also contribute to fungal infections. Medication is available to treat this infection; however, good diabetic control, no smoking and removing and cleaning dentures daily can prevent thrush.

Poor healing: If your diabetes is poorly controlled, you heal more slowly and increase your chance of infection. Keep your blood glucose under control before, during and after any scheduled dental procedure, to increase your chances for a better recovery.

Dry mouth: Some diabetics complain of dry mouth. Dry mouth can be caused by some illnesses and medications such as antihistamines, decongestants, painkillers and diuretics. If left untreated, dry mouth can damage your teeth because there isn't adequate saliva to wash away food and neutralize the acids produced by plaque. Your dentist can recommend several methods to restore moisture, such as artificial saliva and oral rinses. Sugar-free candy or gum also stimulates saliva flow.

What Is the Recommended Home Care?

• Allow about three minutes of brushing to clean all your teeth. Brush at least twice a day with a soft toothbrush.


• Floss once a day or as recommended by your dentist. Flossing cleans away plaque and bits of food from between your teeth and below the gum line. It gets to places your brush can't reach.


• Ask your dentist if you would benefit from a fluoride rinse to help prevent decay.


• If you wear full or partial dentures, clean your dentures daily. Be sure to remove stains and plaque that may build up and irritate your gums. Take your dentures out when you sleep to help your gum tissue stay healthy.

What Dental Visit Considerations Are There for the Diabetic?

• Visit your dentist regularly and tell your dentist you have diabetes.


• Let the dentist know if you have problems with infection or trouble keeping your blood glucose under control.


• Eat before you go to see your dentist. The best time for dental work is when your blood glucose level is on the high side and your insulin action is low.


• Take your normal medications before your dentist visit, unless your dentist or doctor tells you differently.


• Follow your normal meal plan after dental work. If you can't chew well, plan ahead to make sure you meet your nutritional needs.


• If your blood glucose is poorly controlled and you are scheduled to have dental surgery, talk with your dentist to determine if postponing the surgery may be appropriate for your situation.