Gum disease and diabetes have a relationship like a two-way street. According to the American Academy of Periodontology, diabetics are more likely to develop red, infected gums, while gum disease may make it more difficult for people with diabetes to control their blood sugar.

Importantly, periodontal disease is often considered a complication of diabetes. Before we launch further into this discussion, let's take a step back to go over the basics of gum disease.

Gum disease

There are two forms of gum disease: gingivitis (mild-stage gum disease) and periodontitis (advanced-stage gum disease). When someone has gingivitis, gums became red, swollen and bleed easily due to bacteria in plaque irritating the gums. If you've noticed that simply brushing your teeth makes your gums bleed, you should to talk to your dentist about gum disease as soon as possible. At this stage, there is typically no pain or discomfort.

According to the American Dental Association, gingival inflammation tends to be greater in children with Type 1 diabetes than in children without diabetes. The same holds true for adults with Type 2 diabetes. Though it's trickier for people with the disease to maintain great oral health, it's certainly possible.

Here's the big exclamation: Gingivitis is reversible for diabetics with good oral home care and regular visits to the dentist for treatment!

Periodontitis: Advanced gum disease

However, if left untreated, gingivitis can progress to periodontitis. This occurs when plaque spreads below the gum line, allowing toxins to stimulate a chronic inflammatory response in which the gums begin to pull away from teeth. As the disease continues, the pockets (spaces between teeth and gums) deepen and more gum tissue and bone get destroyed. The worst-case scenario involves tooth loss.

Symptoms of periodontitis

Diabetics should pay close attention to their oral health and talk to their dentist and doctor if they notice any of these symptoms of advanced stage gum disease:

• Swollen or tender gums
• Receding gums
• Gums that bleed during or after tooth brushing
• Changes in the way teeth fit together when you bite down
• Persistent bad breath
• Deep pockets that form between teeth and gums
• Loose teeth

Where diabetes comes into play:

Because a person with Type 1 or Type 2 diabetes either can’t produce enough insulin or use it properly, glucose is unable to enter target cells and remains in the bloodstream. These sugars can swarm the mouth, where they may cause cavities and other infections. Everyone knows that sugar causes cavities, but few people realize that diabetes may increase sugar presence in the oral cavity, which may lead to dental caries (cavities).

Severe periodontal disease may increase blood sugar, leading to longer periods of time when the body must function with high blood glucose. This raises the risk among people with diabetes for complications.

In its most basic form, people with diabetes are at a higher risk for cavities and periodontal disease. It's worth pointing out, however, that despite the connection illustrated between the two diseases, more research is needed to clarify how inflammatory periodontal diseases may affect glycemic control, insulin resistance and risk of developing other diabetic complications.

To learn more about oral care and diabetes:

Dental Care and Diabetes
The Importance of Oral Health when You Have Diabetes
Should You Brush Your Teeth After a Nighttime Hypo?