Ask the Dentist
Did you know that people with diabetes are at a higher risk of developing oral health problems? In fact, not taking care of your mouth can make you more susceptible to serious gum disease, which can affect your blood glucose control.
As part of our Ask the Expert series, Ask the Dentist provides an archive of recently and commonly asked questions that are important to diabetes patients. If you have a question for a Dentist – look in these archives first.
If your area of concern is not addressed, we encourage you to contact the Association’s Center for Information and Community Support by sending an email to AskADA@diabetes.org or by calling 1-800-DIABETES.
Recently Asked Questions
- Does pre-diabetes cause dry mouth?
- My dentist said that he could not work on the teeth until my sugars were under control. My concern is that my teeth are so infected that they are causing my blood glucose to read high but I can’t get [my teeth] fixed because [my blood glucose is] so high.
- I am a RDA and I have previously worked for a dentist who recommended certain vitamins for oral health he has since retired and I can't remember which vitamins he recommended. What do you recommend?
- Does diabetes affect the enamel on your teeth?
- My mother has developed thrush twice this year. Are there any safe home treatments in the early stages of the illness?
- My son has type 1 diabetes and after the last two dental check-ups one side of his mouth/face swelled and was painful. Should he be taking something before his next visit or should we wait to see if it happens again?
- My husband has Type 2 diabetes. Over the last couple of years, his tolerance for those loved peppers has gone to zero. Can anything fix this?
- My mom has diabetes and she says that she cannot taste her food when she eats. What would cause that?
- What do you recommend for patients with type 1 diabetes and bad breath?
- My 11 year old son has type 1 diabetes, despite his best efforts he still has bad breath. Why?
Does pre-diabetes cause dry mouth?
Yes, during pre-diabetes there is already important metabolic abnormalities, and some of them have manifestations in the oral cavity. You should visit your dentist more frequently and discuss with him/her the changes you are observing in your mouth. Your primary doctor should also be informed of any changes in your general and/or oral health as this will help monitor more closely your pre-diabetes status.
I have very bad bottom teeth. I have always had soft teeth and now they are literally falling apart. My dentist said that he could not work on the teeth until my sugars were under control. My concern is that my teeth are so infected that they are causing my blood glucose to read high but I can’t get [my teeth] fixed because [my blood glucose is] so high.
Indeed the relation between diabetes and gum disease is two-way. That is, diabetes predisposes to gum disease, gum disease makes diabetes control more difficult and diabetes more severe. However, you need to break the vicious cycle. You should see a periodontist (gum specialist) gum treatment can and should be initiated to begin to reduce the gum infection and inflammation so it would be easier to get your diabetes under control. More extensive periodontal therapy can then proceed as you diabetes control improves.
I am a RDA and I have previously worked for a dentist who recommended certain vitamins for oral health he has since retired and I can't remember which vitamins he recommended. What do you recommend?
Research studies demonstrate that reduced levels of Vitamin C are associated with greater periodontal (gum) disease, that insufficient calcium levels are also associated with more periodontal disease even in young individuals and more so in postmenopausal women. Vitamin D is important in calcium absorption and therefore in maintaining adequate calcium levels. Vitamin E and CQ10 are important too, but there is less research supporting a benefit in oral health.
Does diabetes affect the enamel on your teeth?
Diabetes is associated with low saliva production and dry mouth, which are conditions that increase the risk for enamel demineralization and make enamel more prone to decay. Very good daily oral hygiene with a soft brush and a fluoride containing and plaque fighting dentifrice will reduce this risk greatly. Use of fluoride containing mouthwashes also reduces enamel demineralization.
I am a caretaker for a parent with type 2 diabetes. My mother has developed thrush twice this year. Are there any safe home treatments in the early stages of the illness?
Individuals with diabetes are at higher risk of developing thrush and if not treated completely thrush can become chronic in diabetic patients. A number of conditions increase the risk for thrush in addition to diabetes, such as wearing dentures, dry mouth, antibiotic use, and smoking. You should always consult with your mother’s diabetes doctor to make sure diabetes is well controlled and the medication regime is adequate. Visits to the dentists at least every 6 months are indicated as well. Reducing the other risk factors, such as very good daily oral hygiene, including brushing of the tongue, daily cleaning of dentures, removable partials, as well as disinfection since these can become reservoirs for yeast organisms is important to reduce the risk of reinfection. Drink adequate fluid daily to maintain oral tissues well lubricated, avoid foods or products that can dry the mouth, eating daily yogurt.
My son has type 1 diabetes and after the last two dental check-ups one side of his mouth/face swelled and was painful. The doctor said he had an infection and prescribed antibiotic for 7 days. Should he be taking something before his next visit or should we wait to see if it happens again? Can he take a premedication like people with heart or knee surgery do?
Diabetes is not a medical condition requiring antibiotic premedication. However, your son’s dentist is better qualified to determine whether he needs to take an antibiotic prior to the dental treatment. He knows your son’s dental status and is better prepared to make that recommendation. The practice of rinsing well after the dental cleaning to remove any small lose particles of tartar and plaque that could remain trapped between the teeth reduces the risk of swelling and inflammation after professional cleanings.
My husband has Type 2 diabetes. He has always loved very hot and spicy foods but over the last couple of years, his tolerance for those loved peppers has gone to zero. If he eats anything spicy, the inside of his mouth feels like it is on fire. Is there anything that can be done to fix this?
First of all check with his dentist to make sure the mucosal tissues in his mouth are healthy, moist and well lubricated. It is possible that he has dry mouth, and does not know it. Dry mouth, which is very common in diabetes, could make his mouth feel on fire when eating hot, spicy food.
My mom has diabetes and she says that she cannot taste her food when she eats. What would cause that?
Loss of taste and taste impairment are associated with diabetes. A number of factors can be responsible for the decreased or altered taste sensation in people with diabetes. You should inform your mother’s diabetes doctor of this. He or she will rule out diabetes control and medications use that could affect taste sensation. Your mother should also consult the dentist and have a thorough intraoral examination to rule out oral/dental causes for the loss of taste.
What do you recommend for patients with type 1 diabetes and bad breath? Between brushing 2-3 times a day for 2 minutes, using mouth wash, and chewing sugar free gum, nothing helps. Is there anything else that could be used?
Consult with your diabetes doctor that diabetes is well controlled and with the primary care doctor that you have no stomach conditions (like reflux), post-nasal drip, nasal allergies, sinus problems, inflamed tonsils or adenoids that could cause bad breath. See your dentist to rule out gingivitis, periodontal disease or cavities. Receive regular professional cleanings, brush twice/day with a fluoride and anti-gingivitis toothpaste, floss daily, avoid alcohol-containing mouthwash or maintain your mouth moist.
My 11 year old son has type 1 diabetes. His blood glucose numbers are consistently 90 to 100, his teeth are checked every 4 months, and he flosses and brushes and rinses every morning and night. Despite this, why does his breath still always smell bad?
Sometimes mouth odor can be from sources other than the oral cavity such as post-nasal drip, sinusitis, nasal congestion and allergies. Nasal inhalers, decongestants and other medications to treat allergies cause dry mouth and mouth odor as well. You should consult with your son’s pediatrician or ENT to rule out that his nose and tonsils are not the cause of the mouth odor.
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