The lesser known connection

Periodontal disease is defined as an infection or inflammation that occurs in the gums and bones that support and hold the teeth. If you look up the risk factors leading to periodontal disease you may be surprised to find diabetes listed among many other factors like age, gender, race, tobacco, malnutrition, genetic factors etc. This link between periodontal disease and diabetes is something that is unknown to many including the diabetics.

In other words, if you have diabetes, your chances of getting periodontal disease are slightly higher. It is often listed in diabetes related complications, though not known to people as the other complications related to eye, kidney, cardiovascular etc.

The periodontal disease and diabetes association


Gum disease and infection is linked to diabetic control or in other levels the blood sugar level regulation. Let’s look at 10 factors that can educate us on the Relationship Between Diabetes and Periodontal disease.

1. The Link is Bidirectional

 The relationship between these two are said to be bidirectional. This means that if you have diabetes, especially the insulin resistant variety type 1 diabetes, then you are at a higher risk of developing periodontal disease. Research also suggests that if you control periodontal disease, it could help in the diabetes management as well. However, conclusive studies in the study of this association between diabetes and periodontal disease are still going on.

2. Smoking

  This is another unknown fact to many, but smoking can actually increase the chances of periodontal disease. The chances of a smoker getting the gum disease are said to be five times that of a nonsmoker. It’s already been said that a diabetic’s chance of getting affected is also more. It therefore goes without saying that if you are a diabetic and a smoker, then you have increased the odds of getting affected by periodontal disease.

3. Diabetes Management

Statistics prove that people with low diabetic control are affected more by the gum disease and it is also severe. People actually end up losing their teeth. Children usually are casualties of gum disease since they may not maintain good oral hygiene etc. It is also known that type 1 diabetes, which is an autoimmune disorder if found mostly in children. Hence, these are also a high risk of developing periodontal disease. This is not to say that if you have diabetes and it is managed well, you may still be affected. Studies have proved that control of diabetes will also help in prevention of the periodontal disease.

4. The Blood Vessel Connection

Our body tissues are nourished through the oxygen that is delivered to them by the blood vessels. Blood vessels also help in carrying away the waste from the tissues. And this is true for tissues in our mouth like the gum tissues as well. A commonly known diabetes related complication is that the blood vessels get thickened. And when that happens, they cannot function to their full capacity in nourishing the tissues or helping with the waste removal. This leads to weakening of the tissues and in the mouth is seen as gum infection.

5. The Bacteria Sugar Diabetes Periodontal Disease Link

Diabetes leads to blood sugar level fluctuations especially if not controlled. This can lead to high glucose levels in your mouth as well. Most of the infection causing bacteria thrive in such conditions where they have access to glucose. This can lead to the occurrence of periodontal disease in diabetics. For e.g. thrush is a fungus caused infection in the mouth that happens due to high sugar levels in the saliva.

6. The Dry Mouth Symptom Link

One of the well-known symptoms of diabetes is dryness in the mouth. Most often this happens when the diabetes is yet undiagnosed. At such times the chances of the person getting mouth sores or ulcers or even infections are high. The lack of saliva in a dry mouth contributes to this as otherwise it takes the role of a protector against such issues.

7. Cell Function

Studies have suggested that there is a difference in the way the immune cells of the mouth respond to immune-inflammatory bacteria if one is a diabetic. It has been noted that the cells which are usually among out first line of defense against infections respond in an inhibited manner. This means that they aid the bacteria which cause the infection by not fighting against them as they should and hence periodontal disease occurs.

8. High Levels Of Cytokines

 Glycemic control of diabetes is also linked to the levels of inflammatory cytokines in the gingival crevicular fluid. Studies have proved that diabetics have almost double the levels as that of normal people. This is another factor aiding in the gum inflammation and infection leading to the periodontal disease in diabetics.

9. The Collagen Connection

 When you have diabetes, collagen synthesis and maturation changes occur too. This aids in the development and progress of periodontal diseases in diabetics. This is also the reason why diabetics have a problem with healing of wounds, especially if they undergo oral surgery.

10. Gingivitis

Bleeding Gums

 If you do not brush your teeth properly, then it allows for plaque formation on the teeth. These are actually germs and they cause redness and swelling in your gums and they may even bleed. This is the first stage of the periodontal disease called gingivitis. It is quite possible that a diabetic may ignore this condition out of ignorance or pure carelessness. This can manifest into the more severe condition called periodontitis due to the high glucose and cytokines levels and the altered immune cell functions. This can prove extremely painful and troublesome if not treated immediately.

It is important for diabetics to have:

  • Constant dental checkups (at least once in 6 months) to check for their oral health and catch any possible infection right at the beginning. It can be easily treated and brought under control, especially if the diabetes is under control.
  • The other things to keep a watch are the blood pressure and the blood sugar levels.
  • Maintain good oral hygiene through proper brushing twice a day, using an antiseptic mouthwash if required, proper flossing etc.
  • It is also important to brush your tongue to avoid germs.
  • It is advisable to use toothpaste with fluoride to prevent plaque formation that can in turn lead to periodontal diseases.

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