Links Between Diabetes & Gum Disease The Inflammation Response

Battle against plaque could lead to war on body.

Charles W Martin By Charles W Martin, DDS

Many of my patients who have diabetes are surprised to learn that there's a connection between gum disease and their metabolic management. They're even more surprised when I tell them it's all about inflammation. Here's how it works.

The whole interlocking structure that holds your teeth firmly in place is covered by the gum in a healthy mouth. But the trouble begins when plaque starts to accumulate at the gum line. As the plaque keeps building up, some of the bacteria that make up the plaque can work their way under the gum line. That's a nice, cozy location where bacteria can thrive because it's hard for you to reach them with floss or your toothbrush. They even have a bountiful supply of food from actual food particles that are trapped in the plaque.

Your mouth hosts more than 800 different bacteria. Happy and comfortable, they party in your mouth 24/7. As a byproduct of their lifestyle, they produce toxins. The problem under the gum line is there's no way to get rid of them. As the toxins accumulate they begin to irritate the neighboring gum tissue.

Sensing the irritation, the body responds with an automatic system that's a defense mechanism against inflammation. This is referred to as the body's inflammation response, a complex set of events that send several different types of cells to the site. These cells have specific jobs that are designed to remove whatever is causing the irritation and help the tissue that's been injured to start to heal.

The longer the inflammation continues, the more the body's inflammation response system sends more cells and different types of cells into the battle. The harder the fighting gets, the more the surrounding tissue gets injured.

This is bad enough to have happening in your mouth if you aren't fighting a disease like diabetes. For you, it's worse because of the dangers bacterial infections pose for people with diabetes and because these little partiers in your mouth are thriving on the sugar you have trouble regulating. They're not just having a party in your mouth, they're enjoying unlimited servings of multiple desserts.

How can you know if this is going on in your mouth? You may feel some soreness, you might see the area get red and you could experience some swelling. In a pitched battle, when the inflammatory response cells mount a major counterattack against the bacteria, you may develop an infection as the body's cells try to surround, contain and ultimately destroy the enemy.

Unfortunately, what happens in your mouth doesn't always stay in your mouth. These bacteria can get into your bloodstream and cause irritation throughout your body, which is referred to as systemic inflammation. That, in turn, can cause or contribute to serious and potentially catastrophic health events such as heart attack and stroke, risks that are compounded by diabetes.

The bottom line for people who have diabetes is that it's critical to avoid this inflammation cascade. The best ways to prevent it are by practicing good oral health care at home, and getting regular checkups with a dentist who understands the links between your dental health and your diabetes, and how they affect your prospects for a long and healthy life.

For more information about dental care for people who have diabetes, visit and Dr. Martin's blog,

To learn more about the two-way connection between diabetes and gum disease, check out the other columns here on dLife or Dr. Martin's book, Don't Sugar Coat It.

Read Dr. Charles Martin's bio here.

Read more of Dr. Martin's columns.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition. 

Last Modified Date: July 01, 2013

All content on is created and reviewed in compliance with our editorial policy.

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by Brenda Bell
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