Periodontal Disease and Diabetes: What’s The Link?

Having diabetes increases your risk of having problems with your teeth and gums. Diabetics are more likely to develop gingivitis and periodontitis which can lead to bad breath, bleeding gums, and even tooth loss. Not only that, periodontal disease can make your diabetes worse and increase your risk of other health conditions such as heart disease, cancer, and COPD. 

The good news is that you can prevent gingivitis and periodontitis at home with daily self-care. Taking good care of your gums and teeth will help you control your diabetes and prevent other diseases throughout your body. 

This post explains the link between gum diseases and diabetes and how you can keep your gums healthy!



periodontal disease and diabetes

What is Periodontitis?

Periodontitis is an advanced form of gum disease. It evolves from the mild and treatable form of gum disease, gingivitis. Periodontal disease is a chronic inflammatory condition that leads to the destruction of alveolar bone, and periodontal ligaments that support and hold the teeth in place. 

There are several stages of periodontal disease, mild, moderate, and severe periodontitis. Progression to the advanced form increases your risk of tooth loss and poorly controlled blood sugars.

Diabetes Increases Your Risk of Developing Periodontitis

Diabetic patients are at increased risk of developing gingivitis which without periodontal therapy can progress to mild or chronic periodontitis.

Here are some stats about the incidence of periodontal disease in diabetic patients!

  • Periodontitis is the sixth most common complication of diabetes mellitus (1) 
  • Gingivitis and periodontitis are present in over 47.1% of patients with diabetes mellitus (2) 
  • Periodontal tissue destruction is four times as prevalent in diabetics as in non-diabetic cases (3)
  • Almost 25% of U.S. adults with diabetes ages 50 and older have severe tooth loss, compared with about 16% of those without diabetes (4).


Diabetes Also Causes Other Problems in the Mouth

As well as gingivitis and periodontitis, diabetics are at risk of developing other problems in the mouth. These include

  • dental cavities
  • dry mouth that can cause sores, ulcers, and infections
  • thrush 
  • burning mouth syndrome 
  • uncontrolled blood glucose levels
  • changes in the way foods and beverages taste

These problems can make it difficult for you to eat healthily and thus have an impact on controlling your sugar levels and diabetes. 

How Does Diabetes Cause Periodontal Disease?

High blood sugar affects the gum tissue in several ways.

High Blood Sugars Affect The Saliva

Diabetes and its treatment affect the amount and consistency of the saliva in your mouth. Saliva is the colorless fluid that’s always present in your mouth. 

Saliva is mostly made up of water but also contains electrolytes, mucus, enzymes, and antimicrobial agents. It helps moisten the mouth and neutralizes harmful acids.  It also helps kill germs and defends against gum disease. 

Reduced Saliva Production 

Diabetes and medicines used to control blood sugars can reduce the amount of saliva produced by salivary glands in the mouth. The reduced flow of saliva increases the risk of gum diseases and other oral health problems. 

Increased Salivary Glucose Level 

The bacteria that live in your mouth feed on sugar. As your blood glucose levels increase so does the amount of glucose in your saliva and your risk of gum disease. 

Bacteria combine with food debris to create a sticky film called plaque. When plaque is not disrupted each day it builds up along the gum line and can become hardened by calcium in the saliva. This hardened plaque is called tartar or calculus. 

Plaque and tartar irritate the gums causing inflammation that can result in periodontitis. 

Impaired Cell Production

High blood sugars have been shown to impair the synthesis of cells that help in the production of connective tissues such as collagen which are present in ligaments that help connect the teeth to the alveolar bone. The loss of these fibers ultimately leads to tooth loss (5).   

Increased Number of Inflammatory Cells

Persistently high blood sugars can increase the number of pro-inflammatory factors which destroy bone and irritate the periodontal ligaments and soft tissues. (6) Bone loss results in receding gums and tooth loss.

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You’re Not Alone In Your Fight Against Diabetes and Periodontitis! 

The stats are astounding!

  • About 422 million people worldwide have diabetes (7) 
  • Almost 50 percent of adults in the U.S., who are over the age of 30, have an advanced form of periodontal disease, or gum disease (8). 
  • Just under 50% of those with diabetes have some degree of periodontal disease


What Causes Gum Disease?

Gum or periodontal diseases are a group of conditions caused by some species of bacteria in the mouth. As mentioned above the bacteria along with food debris accumulate to form the soft sticky film called plaque.  The plaque irritates the gums causing inflammation, called gingivitis which as we highlighted above when left untreated advances to periodontitis.

Find out all about Gum Disease.


How Will I Know I Have Periodontal Disease?

The symptoms of gum and periodontal disease are the same for diabetics and non-diabetics. The symptoms are

  • Red, swollen gums
  • Bleeding gums
  • Bad breath (halitosis)
  • Gums that have pulled away from the teeth
  • Gum recession
  • Loose wobbly teeth
  • New spaces between your teeth
  • Abscesses – the presence of pus around the gumline
  • Dry mouth

How Can Diabetics Reduce The Risk of Periodontitis? 

As a diabetic, the two most important things you can do to prevent periodontal diseases are to a) control your blood sugar levels and b) develop and maintain excellent oral hygiene. There are also some other lifestyle choices you can make that will help reduce the risk of developing periodontal diseases with diabetes. 

Control Blood Sugar Levels

Keeping your diabetes under control has a positive effect on your oral health and reduces your risk of developing other health conditions. It will also help reduce acute conditions such as hypoglycemia and hyperglycemia. Talk to your doctor about how best to control your blood sugars. 

Make Good Lifestyle Choices

As well as diabetes several lifestyle choices can increase your risk of developing periodontitis. These positive lifestyle choices can help reduce your risk of developing gum disease and its progression to severe periodontal disease.

  • Quit Smoking
  • Reduce the amount and frequency of sugary foods and drinks
  • Eat a vitamin-rich diet
  • Sip water between meals
  • Reduce stress

Develop Excellent Oral Hygiene

Daily performed self-care is the best way to disrupt the bacteria that cause gum disease. Self-care involves developing and maintaining excellent oral hygiene. It includes brushing the teeth twice a day with fluoride toothpaste and cleaning the interdental spaces daily. Interdental spaces can be cleaned with dental floss, single-tufted toothbrushes, or interdental brushes. 

The revolutionary gum pocket brush cleans along the gum line and between the teeth. It turns off inflammation and gum disease.

I’m Diabetic How Do I Treat Periodontal Disease?

If you have signs and symptoms of the early stages of gum disease or advanced periodontitis seek professional help from expert dentists as soon as possible.

Treatment depends on how advanced your gum disease is. Treatment options include

  • Personalized advice on oral hygiene, controlling blood sugars, and lifestyle choices
  • Professional gum health treatments – scale and polish, root planing.
  • Periodontal surgery  


Is Treatment Of Periodontal Disease Successful In People With Diabetes?

Yes, the treatment of periodontitis in diabetics can be as effective as that in non-diabetic when you have good control of blood sugars. 

If you have poor glycemic control it makes treating severe and even mild periodontitis harder. You can help increase the chances of successful periodontal treatment and reduce diabetes complications by improving the control of your blood sugar levels. 

How Does Periodontitis Affect My Diabetes?

There is a two-way relationship between diabetes and periodontitis. Not only can your diabetes increase the risk of gum disease but severe gum disease can make it harder to control your sugar levels. 

The cells of the immune system which try to eliminate the bacteria in the mouth are not confined to the mouth. The inflammatory cells migrate into the bloodstream where they disrupt the body’s defense system. This in turn affects blood sugar levels. 

Several scientific studies have shown that treating and controlling periodontal disease results in reduced HbA1c –  glycated hemoglobin in the blood. Controlling diabetes (i.e. improving glycaemic control) is likely to reduce your risk and severity of periodontitis.

Frequently Asked Questions

Can Prediabetes Cause Gum Problems?

According to WHO, prediabetics have a condition where blood glucose levels are higher than normal, but not the level to be categorized as diabetes. 

Scientific studies looking at whether prediabetes causes gum problems are limited. However, one study has found that there is a link between prediabetes and periodontal disease. If you have prediabetes, controlling your blood sugars can help reduce the risk of periodontal disease. 

Can A Dentist Tell If I Have Diabetes?

Dentists can’t officially diagnose diabetes. However, they may observe some of the signs and symptoms of diabetes in undiagnosed people with type 2 adult-onset diabetes. They may advise you to contact your doctor. 

Does Diabetes Increase Periodontal Disease

Yes, having diabetes increases your risk of developing periodontal disease and tooth loss. The risk is greater when you have poor control of your blood sugars. 

Final Thoughts

Periodontitis and diabetes are two chronic diseases that can have a significant impact on one another. There is a bidirectional relationship between the 2 conditions. Diabetes is a major risk factor for periodontitis and severe periodontitis can increase blood sugars in diabetics. 

Treating periodontal disease can improve glycemic control, which in turn reduces your risk of diabetes and the associated complications of diabetes.


  1. Awuti G, Younusi K, Li L, Upur H, Ren J. Epidemiological survey on the prevalence of periodontitis and diabetes mellitus in Uyghur adults from rural Hotan area in Xinjiang. Exp Diabetes Res. 2012; 2012:758921.
  2. Nelson RG, Shlossman M, Budding LM, Pettitt DJ, Saad MF, Genco RJ, et al. Periodontal disease and NIDDM in Pima Indians. Diabetes Care. 1990; 13: 836–840.
  3. Emrich LJ, Shlossman M, Genco RJ. Periodontal disease in non-insulin-dependent diabetes mellitus. J Periodontol. 1991; 62: 123–131.
  4. Parker ML, Thornton-Evans G, Wei L, Griffin SO. Prevalence of and changes in tooth loss among adults aged >/= 50 years with selected chronic conditions—United States, 1999–2004 and 2011–2016. Morbidity and Mortality Weekly Report. 2020;69(21):641–646. doi: 10.15585/mmwr.mm6921a1 Accessed here: