Diabetes and gum disease are linked in both directions: poorly controlled blood sugar makes periodontitis more likely and more severe, while advanced gum inflammation makes blood sugar harder to control. A joint consensus of the International Diabetes Federation and the European Federation of Periodontology (Sanz et al., 2018) reports that gum treatment can be associated with a modest fall in HbA1c. If you have diabetes, regular gum checks belong in your overall care.
Why diabetes and gum disease go together
In 1993 Harald Löe called periodontitis the "sixth complication of diabetes". High glucose impairs the immune cells that fight bacteria and slows healing. Sugar-modified proteins build up in the tissues and increase inflammation. As a result, plaque-related gum disease can progress faster and destroy more of the bone that holds the teeth.
The link works the other way too. Periodontitis is a constant, low-grade source of inflammation. Inflammatory signals can reduce the body's response to insulin, as summarised in the review by Preshaw and colleagues (2012).
Warning signs
- Gums that bleed when you brush or floss
- Red, swollen or tender gums
- Persistent bad breath or a bad taste
- Receding gums or teeth that look longer
- Loose or shifting teeth
- Dry mouth or repeated thrush
Early gum disease is usually not painful, so it is easy to miss. The 2018 periodontal classification lists diabetes as a factor that influences how quickly the disease progresses (Papapanou et al., 2018).
Treatment and practical tips
Treatment starts with removing plaque and tartar, followed by deep cleaning of root surfaces under local anaesthesia if pockets are present. Some tenderness for a few days is common. Read more on our gum disease treatment page.
- Book morning appointments and eat and take your medication as usual.
- Bring your latest HbA1c result and a list of medicines.
- Expect more frequent maintenance visits, often every three to six months.
- If you are considering dental implants, stable blood sugar supports healing.
A definitive diagnosis and treatment plan are made by the dentist after the examination.
Frequently asked questions
Can people with diabetes have gum treatment?
Yes, and it is recommended. With good glucose control, healing is usually similar to that of people without diabetes. If control is poor, treatment is planned together with your diabetes doctor.
Will gum treatment lower my blood sugar?
Studies have reported small reductions in HbA1c after periodontal treatment. This does not replace medication or diet. It can, however, support overall control.
Can I have implants if I have diabetes?
Many people with well-controlled diabetes can have implants. Healing problems are more common when glucose is poorly controlled. Suitability is assessed after examination and tests.
References
- Löe H. Periodontal disease: the sixth complication of diabetes mellitus. Diabetes Care. 1993;16(1):329–334.
- Preshaw PM, Alba AL, Herrera D, et al. Periodontitis and diabetes: a two-way relationship. Diabetologia. 2012;55(1):21–31.
- Sanz M, Ceriello A, Buysschaert M, et al. Scientific evidence on the links between periodontal diseases and diabetes: consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International Diabetes Federation and the European Federation of Periodontology. J Clin Periodontol. 2018;45(2):138–149.
- Papapanou PN, Sanz M, Buduneli N, et al. Periodontitis: consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018;89 Suppl 1:S173–S182.
Gum checks in Bahçelievler
If you live with diabetes in Istanbul, regular periodontal check-ups at our Bahçelievler clinic can help protect your teeth. You can message us on WhatsApp in English. See our contact page for details.
Medically reviewed by the dentists of Yayla Dental Akademi.