John C. Chao, DDS, MAGD

Research Associate Professor, Post Graduate Program in Periodontics, SUNY – Buffalo (University at Buffalo)
Adjunct Assistant Professor, Behavior of Science (Anxiety Management), Ostrow School of Dentistry USC

(626) 308-9104

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John C. Chao, D.D.S., M.A.G.D
Anxiety Management,
Behavior Science,
Faculty, USC School of Dentistry

Diabetics At Risk For Gum Disease

According to the American Diabetes Association (ADA), there are 20.8 million children and adults in the United States, or 7% of the population, who have diabetes. Those diagnosed with diabetes number 14.6 million. But 6.2 million have not been diagnosed. These undiagnosed diabetes are especially at risk for heart disease, stroke, vascular disease, nerve damage (neuropathy), kidney disease (nephropathy), and eye disease such as glaucoma, cataracts, diabetic retinopathy and periodontal disease (infection of the gums and supporting jaw bone).

According to the American Diabetes Association, if you have diabetes you are at higher risk for gum disease. Infections can make blood sugar difficult to control. To avoid gum disease the ADA recommends that diabetics learn how gum disease starts, Brush your teeth twice a day, floss your teeth every day, look for early signs of gum disease and visit your dentist twice a year. That is also what the American Dental Association advises everyone.

Periodontitis starts when "plaque" is not regularly removed from the teeth. Plaque is a sticky film of food, saliva and germs. If not removed, gums may peel away from the teeth and pockets form between the teeth and gums. These pockets will deepen and become filled with germs and pus. Loss of teeth or extensive dental treatment may result.

Diabetics are advised to see the dentist if these early signs of gum disease are detected:

  • Bleeding gums when you brush or floss
  • Red, swollen or tender gums
  • Pus between teeth and gums
  • Bad breath
  • Permanent teeth loose or moving away from each other
  • Changes in your bite
  • Changes in the fit of partial dentures or bridges

Before a dental appointment, the diabetic should:

  • Tell your dentist you have diabetes and what problems you have with infection or blood sugar level.
  • Eat before you go to the dentist. The best time for dental work is when your blood sugar level is in a normal range and your diabetes medication is low. If you take insulin, a morning visit after a normal breakfast is best.
  • Take your usual medicines before your dental visit, unless advised otherwise by your dentist or physician.
  • Stick to your normal meal plan after dental work. If you can't chew well, plan how to get the calories you need. You may need to use your sick-day meal plan that uses more soft or liquid foods.
  • Wait to have dental surgery until your blood sugar is in better shape, if your diabetes is in poor control. If the need is urgent (pain or swelling) talk to your dentist or physician about treatment in the hospital or a special outpatient surgical setting.


According to the ADA diabetics should be especially careful about any signs of oral infections that can stem from cavities, as well as gum disease. Persistent pain and welling, pain when chewing, sensitivity to sweet, cold and hot are some of the symptoms to watch out for.

Diabetics are also prone to fungal infection in the mouth, called thrush. Signs include white or red patches that turn into ulcers. Smoking and wearing dentures can increase the risk of thrush.

Poor healing is another risk of the diabetic after dental treatment. Blood sugar should be kept under control before, during and after surgery.

Many diabetics complain of dry mouth. This may be due to medications, or when blood sugar is high. Dry mouth can increase the risk of cavities, gum disease and even salivary gland infections.

Brush your teeth twice a day, floss your teeth every day, look for early signs of gum disease and visit your dentist twice a year. That is also what the American Dental Association also advises everyone.

See your dentist regularly and discuss your special concerns as a diabetic. See your physician as directed.


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