Brush your teeth twice a day, floss when you remember, swish with mouthwash, and repeat. That’s often the extent of what people consider an acceptable oral routine— but for those with type 2 diabetes, oral care encompasses much more than clean teeth.
November is National Diabetes Month, and it’s a good time to consider what your mouth might be telling you about your health.
“The mouth is a gateway to the body,” Dr. Jamar McKay, DMD, of Express Smile Buckhead in Georgia told The Root. While people may separate oral health from overall health, McKay emphasizes that everything is related. Gum disease, which can inflame tissues around your teeth, can be linked to other conditions, including uncontrolled diabetes and high blood pressure, McKay said.
So what does that connection mean for someone living with diabetes? McKay said the mouth can affect the body, and the body can also affect the mouth. Diabetes can make it harder to fight infection, leaving the gums more vulnerable, according to the Mayo Clinic. When gum disease sets in, bacteria and inflammation enter the bloodstream.
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For people with diabetes, that makes it harder to control blood sugar levels. The good news is that the CDC says treating gum disease can improve blood-sugar control in people with diabetes. This is an important factor for Black Americans who, according to the Office of Minority Health, were 24 percent more likely to have diabetes in 2024 and 78 percent more likely to die from it than the general population in 2022.
What You Can Do Now
McKay said to start by paying attention to how you clean your teeth. Use a soft- or medium-bristled toothbrush and brush in circles, angling the bristles toward the gumline. Scrubbing hard and brushing side to side can wear on teeth and cause gums to recede. If you have an electric toothbrush, let it do its job. Too much pressure can damage your gums.
For flossing, McKay suggests curving the strand around each tooth, cleaning along its side, then repeating on the neighboring tooth. He encourages patients with diabetes to follow traditional flossing with a water flosser to flush out debris.
And don’t skip a checkup just because everything feels fine. “The thing with dental is once you start to have pain, the problem has progressed further,” McKay explained. He generally recommends visits every six months, or every three to four months for someone with gum disease.
Don’t Ignore These Signs
Saliva does more than keep your mouth moist. McKay said it washes food and bacteria away from teeth, carries immune factors and helps maintain the mouth’s pH balance. Reduced saliva flow can weaken that protection, leaving teeth more vulnerable to cavities. “It’s something so natural, just saliva. But when there’s an imbalance of that, we can have issues,” McKay said.
Dry mouth is common among people with diabetes, so he recommends drinking plenty of water throughout the day to combat it. Persistent dryness is worth mentioning to your dentist, as McKay said it could be related to elevated blood sugar, dehydration or certain medications.
He added that consistent bleeding during brushing or flossing is a reason to check in with your dentist and indicated that some offices test saliva flow and pH.
Don’t Assume Care Is Out of Reach
If you don’t have insurance, McKay said some cities offer free or reduced-cost dental services. If cost is keeping you from an appointment, it may be worth asking your dental clinic about payment discounts or plans.
McKay’s parting advice on oral health and diabetes? Simply put, “Pay attention to changes in your mouth.”
