Diabetes and oral health are linked: Here's what you need to know

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Imagine trying to enjoy your favourite meal but finding that your gums hurt, your mouth feels dry and chewing has become uncomfortable. For people living with diabetes, this can be a daily reality that often goes unrecognised.

Diabetes care routinely focuses on the heart, feet, eyes, liver and kidneys. The mouth, however, is frequently overlooked, even though oral health both affects and is affected by diabetes in important ways.

One in nine adults worldwide has diabetes, and more than four in ten do not know they have the condition. By 2050, global projections indicate that one in eight adults, around 853 million people, will be affected, an increase of 46 per cent.

Understanding the two-way connection between diabetes and oral health is therefore essential. It is not about achieving a Hollywood smile. Keeping diabetes under control supports good general and oral health in turn helps improve overall wellbeing.  Diabetes influences how the body processes sugar. When blood sugar levels remain high for long periods, they damage blood vessels and nerves, slow healing and weaken the body’s ability to fight infection. The mouth having soft and hard tissues and naturally diverse community of bacteria, becomes particularly vulnerable.

Oral health complications linked to diabetes include dry mouth caused by reduced saliva, high risk of tooth decay, gum disease involving inflammation and bone loss around the teeth, oral infections such as thrush, mouth ulcers, difficulty wearing dentures, changes in taste and ultimately tooth loss. These problems can affect nutrition, confidence and even blood sugar control.

My latest study showed a clear association between type 2 diabetes and severe dental decay. High blood sugar, combined with changes in saliva quantity and quality, may contribute to this progression. Many people are unaware of this link, which creates a vicious cycle. However, dry mouth and the dental decay that follows can often be prevented if awareness is increased among the public and healthcare professionals.

Gum disease and diabetes

People with diabetes are more likely to experience gum disease, and the relationship works both ways. Diabetes increases the risk of gum disease because high blood sugar leads to more sugar in saliva. Bacteria in the mouth feed on sugar and produce acids that irritate and damage the gums. Once the gums become infected, the supporting bone around the teeth can shrink. As bone is lost, teeth may become loose or fall out. Keeping blood sugar within a healthy range and maintaining good oral hygiene significantly lowers this risk. 

 

Dry mouth and tooth decay

Dry mouth is another common issue for people with diabetes. Around 20 per cent of the general population experiences dry mouth, with higher numbers seen in women and older adults. Certain medications used for treating blood pressure, depression or nerve pain can make dryness worse.

Saliva is the mouth’s natural protection. It washes away food particles, neutralises acids and helps prevent infection. Without enough saliva, the mouth becomes more acidic and teeth lose minerals, which increases the risk of decay. Dentists can offer personalised prevention plans for people at higher risk. These may include fluoride varnishes, specialist mouthwashes or high-fluoride toothpaste.

Saliva also plays a vital role for denture wearers. It cushions the gums, stabilises dentures and reduces irritation. When the mouth is dry, dentures can rub and cause discomfort, ulcers and infections such as oral thrush. Good denture care can greatly improve comfort, eating and overall health, including cleaning dentures daily, removing them at night, brushing the gums and tongue, using suitable cleaning solutions rather than hot water and attending regular dental check-ups to ensure a proper fit.

Dental implants are another option for replacing missing teeth, but diabetes must be well controlled before they are considered because high blood sugar slows healing, increases infection risk and makes it harder for the bone to fuse properly with the implant. Healthy gums, stable bone levels and good oral hygiene are essential for implant success. Dentists need to assess each person’s situation to determine whether implants are appropriate.

Good mouth care can make eating easier, support blood sugar control and improve quality of life. Staying informed, building healthy daily habits and attending regular dental check-ups all help manage the oral health complications linked to diabetes.