About the Conditions

Diabetes is one of the leading causes of death in the U.S., affecting nearly 26 million Americans. Diabetes causes the body not to produce or properly supply insulin, a hormone needed to convert sugar
(or glucose) into energy. People with diabetes may experience a host of other systemic complications, including periodontal disease.

Periodontal disease is an inflammatory response to a bacterial infection in the gums. If left untreated, the disease may cause damage to the tissues and bone surrounding the teeth, possibly leading to tooth loss. People with diabetes are two to four times more likely to develop periodontal disease than those without diabetes. Additionally, people with diabetes tend to experience more severe levels of bone loss and more aggressive disease activity.

Links and Increased Risks

The tooth loss seen as a result of severe untreated periodontal disease can make chewing and digesting food difficult, having a negative impact on a diabetic’s ability to maintain proper nutrition and control his or her blood sugar levels. Periodontal disease also raises a person’s systemic inflammatory signals, which increase blood sugar. It is important for people with diabetes to treat periodontal disease to eliminate the infection for optimal metabolic control.

A series of 2012 consensus reports from the American Academy of Periodontology and the European Federation of Periodontology indicate “an independent association between moderate periodontitis and an increased risk for the development or progression of diabetes.” The shared culprit in periodontitis and diabetes is inflammation, which can aggravate both conditions.

Diagnosis and Treatment

Although a regular oral hygiene routine is important for everyone to follow, people with diabetes should be particularly diligent about how they care for their gums and teeth. In addition to brushing twice a day and flossing regularly, people with diabetes should undergo a yearly comprehensive periodontal evaluation. If periodontal disease is detected, a periodontist can provide treatment that can stop the disease and bring the gums back to a state of health, preventing additional bone or tooth loss. In fact, periodontal treatment has been shown to improve blood sugar levels in people with diabetes.

Depending on the patient’s unique case, the periodontist will advise on next steps for treatment and care. Patients are advised to develop an informed care team—comprised of a periodontist, physician, and other necessary health professionals—that work together in monitoring and addressing changes in their diabetes or periodontal health statuses.  


People with diabetes may want to schedule their dental appointments early in the morning after they have eaten a normal breakfast in order to stabilize blood sugar and prevent a severe or sudden drop in blood sugar levels.