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Diabetes is a chronic disease that has some well-known side effects. One of the newer complications that have been attributed to diabetes is gum disease. We explore the link between gum disease and diabetes in this article.

Diabetes is one of the fastest growing chronic diseases in the world [1] and has been closely associated with gum disease as well. There has been a huge amount of research in trying to investigate a link between diabetes and gum disease. Can diabetes cause gum disease? Can gum disease cause or effect diabetes? Does having diabetes mean that you are more likely to have gum disease? These are all questions that have now been definitively answered.

Why Diabetes and Gum Disease?

Numerous studies found that people suffering from diabetes were significantly more likely to be suffering from gum disease [2]. This finding was later expanded on researched further to reveal that the severity of gum disease, the rate of progression of gum disease, and the number of teeth affected by gum disease were all much higher in uncontrolled diabetics [3].

It worked the other way as well. Dentists started noticing people that were coming for bleeding gums treatment or other signs of gum disease were more likely to be suffering from diabetes as well [4].

Can Diabetes Cause Gum Disease?  

This was a highly debatable question a few decades back when research into this topic started out. Gum disease has been found to be conclusively be caused by the accumulation of disease-causing plaque on the surface of the teeth [5]. Where is the role of diabetes in that?

What we know now is that while the presence of disease-causing plaque is a pre-requisite, the immune response of the body to the plaque is equally important. In people suffering from uncontrolled diabetes, the immune response of the body is compromised and allows the bacteria to cause an increased amount of destruction in a shorter amount of time [6].

Diabetic end products which attracted inflammatory molecules from the body were found in the gums and the surrounding periodontal tissues. This is again direct evidence of the role that diabetes plays in causing gum disease [7].

Research also found that the kind of bacteria inhabiting the mouth is affected by the presence of uncontrolled diabetes. A higher percentage of disease-causing bacteria is found in uncontrolled diabetes, which increases the likelihood of developing gum disease greatly.

Gum disease can occur around the natural teeth as well as artificial implants. Here, too, the effect of uncontrolled diabetes is clear to see. Gum disease around the implants is called peri-implantitis and is seen much more commonly in patients that have poorly controlled diabetes.

In fact, one of the main risk factors for implant failure is uncontrolled diabetes, so the current recommendation is for the systemic disease to brought under control before placing dental implants [8].

Can Treating Diabetes Help Treat Gums Disease As Well?

This was the next test of the relationship between diabetes and gum disease. If a factor is causing the faster progression of the disease then its elimination should theoretically slow down the progress of the same disease as well.

This was exactly the case with diabetes and gum disease.

Patients that were suffering from gum disease responded better to treatment once their diabetic control improved. All the parameters of success like pocket depth reduction, bleeding gums, loose teeth, or loss of teeth were found to be better in well-controlled diabetics than uncontrolled diabetics receiving the same kind of treatment [9].

Can Gum Disease Affect Diabetes?

This was the last question that was raised when the link between gum disease and diabetes was found to be so strong. Research into the underlying common mechanism by which inflammation affects both gum disease and diabetes has indicated that gum disease can play a definite role in the diabetes control of the patient.

Our gums are significant in surface area when taken as a whole, almost the size of the average sized human fist and so uncontrolled gum disease indicates that a significant portion of the body is suffering from inflammation.

This releases inflammatory modulators in the body that can attack the insulin receptors and make them non-responsive to insulin, thus increasing the severity of diabetes directly. It is important to remember that the causes behind insulin resistance and diabetes are varied. Gum disease is probably one of the many small things that can affect diabetes control [10].

It is not like getting bleeding gums treatment is going to cure diabetes but it is definitely going to help the patient exercise better control over the disease. A lot of diabetes care centers are now becoming aware of this link and recommending that patients have their gums treated in case of diabetes which does not seem to be responding to treatment as expected.


Both diabetes and gum disease are chronic conditions which are manageable but never really fully curable. The risk of the disease worsening due to a lack of care is always present. We believe that the link between diabetes and gum disease must be made aware to more people so that they can seek the correct treatment at the right time.

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