Diabetes and Gum Disease: What's the Connection?

People with diabetes are three times as likely to develop severe gum disease as people who don’t have diabetes. Conversely, if you have gum disease, your chance of developing type 2 diabetes is more than double. Here’s why.

gum disease

Along with heart disease, kidney disease, and other chronic health conditions, gum disease is a potential complication directly associated with diabetes. The link is so strong that researchers not only believe people with diabetes are at higher risk of developing gum disease, they also suspect that gum disease may, in turn, contribute to further progression of diabetes. Poor blood glucose control puts you at even higher risk of developing gum disease in the form of gingivitis (early stage gum disease) and periodontitis (more advanced gum disease).

How it Works

Because of the effects of hyperglycemia (high blood sugar) on the immune system and the body as a whole, people with diabetes are more prone to infection than those who do not have diabetes. Gum disease is a bacterial infection. Infection, in turn, can cause spikes in blood sugar, making it harder to control diabetes symptoms. According to Dr. Gerry Curatola, Clinical Associate Professor in Cariology and Comprehensive Care at New York University College of Dentistry and founder of Rejuvenation Dentistry®, gum disease is one of the body’s leading sources of chronic, low-grade inflammation. This inflammation ravages the body and contributes to heart disease, Alzheimer’s disease, and even cancer.

High cholesterol and blood fats are also common in people with diabetes, and these conditions can lead to immune system complications and inflammation, both of which are also linked to insulin resistance and the development of diabetes. Periodontitis may also increase cholesterol and blood fats, further complicating an existing condition, and increasing the risk of both the development and progression of diabetes symptoms.

What You Can Do

According to Dr. Curatola, there are several steps you can take to help prevent the onset and progression of gum disease. These steps help support a healthy oral microbiome, the natural bacterial community in your mouth. In addition to consistently monitoring your glucose levels to keep them under control, Dr. Curatola recommends that you:

  • See your dentist and dental hygienist every 3 months. For those without diabetes, 6-month visits are fine, but for those with diabetes, cleaning and checkups “once per season” will effectively interrupt the cycle of gum disease and provide important dental care and support.
  • Keep your dentist informed. Let your dental health care providers know that you have diabetes, and keep them abreast of any changes in your condition or the way you are treating it, such as new medications. This is particularly important if there is a need for restorative dentistry, such as crowns or implants because the condition of your gums is akin to the condition of a foundation when building a house; it must be strong and supportive.
  • Maintain good oral hygiene at home. Carefully brush and floss at least twice a day. Dr. Curatola recommends using natural toothpastes, and avoiding toothpastes made with harsh chemicals such as triclosan, sodium laurel sulfate and fluoride. He also says to avoid alcohol-based mouthwashes and those that contain chemicals such as cetylpyridinium and chlorhexadine. These products disturb the natural environment of the mouth. If you wear dentures, remove them regularly and clean them daily.
  • Follow a healthful diet. Good nutrition is a cornerstone to both diabetes management and oral health. Dr. Curatola recommends what he calls an “AAA” diet that is rich in antioxidants, alkalizing, and anti-inflammatory to help promote a healthy oral microbiome. In short, that means avoiding simple carbs such as refined white flours and sugars, and eating a whole-food diet, including foods that are rich in healthy fats like olive oil and omega-3 fatty acids.
  • Limit alcohol and quit smoking. In addition to the other known health risks of overindulging, those who drink regularly and smoke create an imbalanced oral environment, leading to a breakdown of the oral microbiome and leaving your mouth and gums more prone to disease.