can diabetes cause gum problems

India has a very large number of people living with diabetes, and many more who have it without knowing. Dentists often see the gums react before the diagnosis is made. Repeated gum boils, gums that bleed heavily despite brushing, or slow healing after an extraction can all be hints that sugar levels need checking. If you have diabetes, your gums deserve the same regular attention as your eyes, kidneys and feet.

Why diabetes affects the gums

• Stronger inflammation. High blood sugar makes the body's inflammatory response exaggerated, so plaque that would cause mild gingivitis in someone else can cause more destruction.
• Slower healing. Small blood vessels are affected and white blood cells work less effectively, so infections take longer to settle.
• More infections. Gum abscesses are more frequent when sugar is high.
• Dry mouth. Diabetes and some of its medicines reduce saliva, which normally helps wash plaque away.
• Thrush. Fungal infections in the mouth are more common.

The two-way link

Gum disease is a long-standing inflammation. That inflammation can make the body less responsive to insulin, so blood sugar can be harder to control while gum disease is active. Studies suggest that treating gum disease can bring a modest improvement in long-term sugar readings. It is not a substitute for your diabetes medicines, but it is one more reason to treat the gums properly.

Warning signs to watch for

• Gums that bleed easily or look red and puffy.
• Repeated gum boils or swellings.
• Bad breath or a bad taste that does not go away.
• Teeth that are loosening or shifting.
• Slow healing after an extraction or a small mouth injury.
• A dry, burning mouth.

Practical advice if you have diabetes

1. Tell your dentist. Bring your latest reports, including your HbA1c (the three-month sugar average), and a list of medicines.
2. Eat normally before your appointment and take your medicines as usual, so your sugar does not drop in the chair. Tell the team at once if you feel shaky or sweaty.
3. Get your gums measured, not just your teeth checked. A quick look does not show pockets.
4. Keep maintenance visits regular. Your dentist may suggest cleanings more often than for someone without diabetes.
5. Clean between your teeth every day.
6. Avoid tobacco, which adds its own risk on top of diabetes.

Before gum surgery or extractions

Our working policies ask that blood sugar, blood pressure and thyroid be under control before surgery. Poorly controlled diabetes increases the risk of infection and slow healing afterwards, so your dentist may postpone a planned procedure and coordinate with your physician. Emergency treatment for pain or infection is not delayed for this reason; it is adjusted to keep you safe.

If you have diabetes and bleeding gums, it is worth booking a gum assessment. Read our periodontitis page for more, and see our MDS periodontics department for specialist gum care.