Diabetes and Dental Care: Your Guide to a Healthy Mouth

Here's why regular visits to the dentist are important—especially if you have diabetes

toothpaste on toothbrush

For people with diabetes, poor blood sugar control can increase the risk of gum problems. In fact, studies have shown that people with diabetes are nearly three times as likely to develop periodontitis, a disease that can cause the decay of teeth and gums over time.

But as long as you take an active role in maintaining proper oral hygiene and scheduling regular checkups with your dentist, these types of problems can easily be avoided.

"Many people just don't brush long enough. Most of us brush less than a minute," says Cynthia Sherwood, DDS, FAGD, a spokesperson for the Academy of General Dentistry (AGD).

She offers these three big tips for a healthy mouth when you have diabetes.

1. Focus on flossing

It may seem like a hassle, but it's a necessity for a healthy mouth. “Flossing is just as important as brushing. Not flossing puts you at an increased risk for developing gum disease,” Dr. Sherwood says. Floss goes where your brush can't—between your teeth—to remove plaque and debris, and it can also help reduce bad breath.

Floss before you brush, both in the morning and before bed, to remove all the food and plaque you built up during the day. Make sure to floss up and down, and around your teeth, to ensure you're getting in all the nooks and crannies.

Your doctor may recommend using mouthwash if you have issues with halitosis or need fluoride. The AGD recommends avoiding mouthwashes that contain high levels of alcohol (18-26 percent), which can dry out the mouth and produce a burning sensation. To get the full benefits, swish for 30 seconds, and then avoid eating, drinking, or smoking for 30 minutes after spitting it out.

2. Brush up

When you brush, and for how long you brush, matters. "To effectively reach all areas and scrub off cavity-causing bacteria, it is recommended to brush [after breakfast and before bed] for at least two minutes," Dr. Sherwood says.

If your gums are bleeding, the most likely culprit is plaque caused by inadequate brushing and flossing. "If plaque sits on teeth and under the edges of the gums for more than 24 hours, it forms toxins that cause inflammation and bleeding. So the soreness and inflammation just gets worse and worse," Dr. Sherwood says. "I see a lot of patients who tell me that if their gums bleed, they try not to brush them because they are afraid that it will make it worse and it will hurt," she says. Instead, make sure you're brushing thoroughly and for at least two minutes—and if it doesn't get better after a week, head to your dentist for professional help.

There is, however, such a thing as brushing too thoroughly. When you brush, make sure not to saw back and forth and press hard, but opt for gentle circular motions across each tooth. After brushing, swish with water and remove any excess toothpaste. Opt for soft bristles (harder bristles can damage gums) and replace your brush whenever it begins to show wear, or after 90 days—whichever comes first.

3. Steer clear of sugary drinks and foods

While flossing and brushing are musts for everyone, what you eat can hurt or help your teeth. And that's especially true for those with diabetes.

"Sports and energy drinks and soda can cause harm to teeth. The high acidity levels in these drinks erode tooth enamel, the glossy outer layer of the tooth," Dr. Sherwood says. "Damage caused to tooth enamel is irreversible, and without the protection of enamel, teeth become overly sensitive, prone to cavities, and more likely to decay," she says.

A study by the AGD found that eating cheese with a glass of wine or after a meal can help balance acidity levels in the mouth, which protects tooth enamel. Low-fat cheese worked just as well as full-fat, which is good news for your healthy diet.