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%.
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.
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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% 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.