Caring for Someone with Diabetes? Don't Forget About Their Oral Health

When people think about diabetes, they often focus on blood sugar levels, medications, diet, and exercise.

However, one area that is often overlooked is oral health.

For older adults with diabetes, problems in the mouth can become serious if they are not addressed early.

Dry mouth, gum disease, cavities, and oral infections are all more common among people living with diabetes.

As a caregiver, knowing what to watch for can help prevent small problems from becoming major ones.

Why Diabetes Can Affect the Mouth

According to the National Institute of Health, Saliva plays an important role in protecting the teeth and gums. It helps wash away food particles and harmful bacteria that can contribute to tooth decay and gum disease.

Diabetes can reduce saliva production.

When there is less saliva, bacteria can grow more easily, increasing the risk of cavities, infections, and gum disease.

High blood sugar levels can also increase the amount of glucose found in saliva.

This extra sugar provides food for harmful bacteria, allowing plaque to build up more quickly on the teeth and along the gumline.

If plaque is not removed through brushing and flossing, it can harden into tartar, which can contribute to gum disease.

Unfortunately, untreated oral health problems can have serious consequences.

Research has found that adults age 50 and older with diabetes are more likely to experience severe tooth loss compared to those without diabetes.

To make matters worse, gum disease can be more severe and take longer to heal in people with diabetes.

Signs Caregivers Should Watch For

Many older adults may not realize they are developing oral health problems.

Caregivers are often the first to notice changes. Paying attention to changes in the mouth, eating habits, or complaints of discomfort can help identify problems early and prevent them from becoming more serious.

Possible Signs of Gum Disease

• Red, swollen, or tender gums

• Bleeding gums

• Gums pulling away from the teeth

• Loose or sensitive teeth

• Pain while chewing

• Changes in how the teeth fit together

• Changes in the fit of dentures

Signs of Dry Mouth

• Dry or sticky feeling in the mouth

• Thick or stringy saliva

• Bad breath

• Difficulty chewing, swallowing, or speaking

• Dry or sore throat

• Changes in taste

• Problems wearing dentures

• Dry or cracked lips

Oral Thrush is a fungal infection that can occur more often in people with diabetes.

Symptoms may include:

• Creamy white patches inside the mouth

• Redness or soreness

• Burning sensations

• Cracking at the corners of the mouth

• A cotton-like feeling in the mouth

• Loss of taste

• Irritation underneath dentures

Other signs you should look out for:

• loose teeth

• increasing spaces between teeth

• bad breath that doesn’t go away when you brush your teeth

Tips for Better Oral Health

1. Monitor Their Mouth Regularly

Take a few moments each day or week to look for signs of the oral health problems discussed above. You can observe their mouth while they are eating, brushing, or flossing. Difficulty chewing, complaints of pain, bleeding gums, changes in eating habits, or reluctance to perform oral hygiene may also be signs that something is wrong.

2. Encourage Proper Brushing

The American Dental Association recommends brushing twice daily for at least two minutes each time.

Make sure they brush:

• The front and back of every tooth

• The chewing surfaces

• The tongue

• Along the gumline
  

If arthritis, weakness, or mobility challenges make brushing difficult, consider:

• Electric toothbrushes

• Ergonomic toothbrush handles

• Foam tubing attachments that make toothbrushes easier to grip
  

Make sure to replace toothbrushes every few months.

3. Don't Skip Flossing

Brushing alone cannot remove all food particles and plaque between teeth.

The Centers for Disease Control and Prevention recommends cleaning between teeth daily.

If traditional floss is difficult to use, consider:

• Floss picks

• Water flossers

• Other interdental cleaning devices

  
  

4. Schedule Regular Dental Visits

Most adults benefit from seeing a dentist at least twice a year, although some people with diabetes may need more frequent visits.

Ask the dentist how often appointments should be scheduled based on the individual's specific needs.

Always inform the dental team that the person has diabetes and share any oral health concerns you have noticed.

Before the visit, be prepared to discuss:

• The type of diabetes they have

• Current medications

• Recent blood sugar control

• Most recent A1C results

• Episodes of low or high blood sugar

• Other health conditions such as heart disease, kidney disease, or neuropathy

• Any mouth discomfort, dryness, or sores
  

For many people with diabetes, morning dental appointments may be preferable because blood sugar levels are often more stable. Encourage your loved one to eat normally and take medications as directed unless instructed otherwise by their healthcare provider.

In some situations, it may be helpful to coordinate care between the dentist and primary care physician.

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