Diabetes and oral health: A bi-directional relationship

Posted by Saleha Ali-Sahib - 02 Sep 2022

Diabetes and oral health share a bi-directional relationship which means that having diabetes makes a person more prone to developing many different types of oral conditions and, if you already have these oral conditions then that affects your sugar level

How does diabetes affect my oral health?

- Higher blood glucose level impairs the body’s ability to fight therefore, they are prone to developing bacterial, viral, and fungal infections in the mouth.

- Higher levels of glucose in saliva promote the growth of plaque.

- High blood sugar also interferes with healing.

Oral conditions:

- Caries: High blood sugar level increases the sugar levels in your saliva, as well which encourages the growth of dental plaque on your teeth; plaque is one of the factors that causes tooth decay as it coats your teeth and bacteria in it produce acid which harm your teeth.

- Xerostomia/Dry mouth: Xerostomia occurs when your salivary glands don't produce sufficient saliva to keep your mouth moist therefore, causing tissues in your mouth to become swollen, dry, cracked and sore, and also increasing the bad bacterial load in our oral cavity. Having less saliva in the mouth means that one of the important protective factors protecting the teeth is not there.

- Candida Albicans : Our mouths have a balance of good bacterial and fungal species. They’re not doing damage, they are there to keep the mouth healthy. Candida albicans is a fungus that normally lives inside the mouth. When you have uncontrolled diabetes, deficient saliva in your mouth and high sugar in your saliva allows the fungus to cause an infection called candidiasis (thrush), which appears as sore white or red areas in your mouth.

- Gum disease : There are two types, gingivitis and periodontitis. Gingivitis involves inflammation of the gums while Periodontitis is a more advanced disease process involving inflammation and loss/deterioration of the periodontium (tooth supporting structures such as gums, bones and fibers attaching our tooth to the jaw). Gingivitis is reversible while periodontitis is not; it is unable to be cured and requires regular maintenance. Due to both conditions being inflammatory, your body’s reaction to the inflammation process could lead to elevation of glucose levels as well. As this is a bi-directional relationship, it also means that having high glucose levels will increase bacterial load in the oral cavity, slow down healing, and increase susceptibility of your condition worsening and in worst cases, result in tooth loss.