Current realities overlooking dental care

Life moves fast. Whether you're a student, parent, busy professional, or carer, and managing Type 1 Diabetes (T1D), it's easy to let dental care slide.

But here’s the truth: oral health plays an important role. Poor dental health can lead to pain, infections, and make it harder to manage blood sugar. Brushing, flossing, and regular dental visits are more than good habits, they're part of staying healthy with T1D.

Back to basics – how diabetes and oral health are connected

Your mouth and blood sugar are more connected than you’d think. Healthy gums can help keep blood sugar levels stable. But if your gums are swollen, sore, or bleed easily, these could be signs of gum disease, which makes diabetes harder to manage.

People with T1D are more likely to get gum disease because high blood sugar weakens the body’s immune system and slows down healing. It was found that severe gum disease, called periodontitis, can lead to inflammation in the whole body (Pussinen and Salomaa, 2018). This can raise the risk of problems with the heart, kidneys, and other organs. When diabetes isn’t well managed, it’s harder for the body to fight infections and heal, which makes gum disease worse.

What makes dental care harder among people with T1D?

People with T1D often have low blood sugar at night, called hypoglycemia. The main goal is to fix it quickly by eating or drinking with fast-acting sugar like candies or juice. But after that, oral care is often forgotten.

When the pH in your mouth (which measures how acidic or basic something is) doesn’t return to normal after taking sweet or acidic treatments for low blood sugar, it can harm your enamel (the hard outer layer that protects your teeth). Sugar feeds bacteria in your mouth, they produce acid that weakens enamel. Over time, this can cause cavities, gum disease, and other dental problems.

Let’s learn from Jyotsana Rangeen’s journey living with T1D for 9 years:

"Midnight lows are one of the hidden challenges of T1D - especially when you're half-asleep, reaching for juice or candy. I noticed the sugar affected my dental health if I didn't brush afterward.

I saw early signs of enamel wear, so I became more intentional about my nighttime dental care. Now, I keep a soft toothbrush and fluoride rinse by my bedside. These small habits make a big difference. A confident smile helps me feel good, even in the chaos of T1D. I’m grateful for the lessons this journey teaches me every day!"

According to the World Health Organization (2017) and the 2015 Global Burden of Disease Study, tooth decay is one of the most common health problems worldwide. It happens when people eat too much sugar and don’t clean their teeth well. If left untreated, it can cause pain, infections, and difficulty eating or sleeping, and may even affect growth and overall health. In places with limited access to care, many people have teeth removed due to lack of affordable dental services.

What now?

Dr. Dominika Antoniszczak, a dentist from Poland who lives with T1D for 7 years, asked in her research, “do you think I brushed my teeth after a 3 a.m. hypo?” Her study explored the real struggles people with T1D face in dental care.

Here are insights from people w/ T1D (D. M. V. Antoniszczak et al., 2022):

Male, T1D for 19 years, “I got gum disease at the age of 29. Poor blood sugar control in my teens made it worse. It affects my mental health now.”

Female, T1D for 25 years, “I avoid fruit juice because it’s acidic and causes tooth decay, but it’s also the best fix for low sugar.”

Male, T1D for 40 years, “Before using a continuous glucose monitoring (CGM), I had more night hypos and more dental problems. Since CGM, I rarely have hypos at night, and my teeth are okay.”

Here are the tips from Dr. Dominika about handling nighttime hypos, especially for people who struggle with oral care afterward:

After a nighttime low, build a habit to rinse your mouth with water or mouthwash before going back to sleep.

Use fluoride toothpaste (ask your dentist about the right fluoride level) and floss regularly.

See a periodontist, a dentist who specializes in gum disease, for proper care.

Let's keep our smile

Keeping blood sugar levels within 70–180 mg/dL (3.9–10 mmol/L) for at least 70% of the day (about 16 hours) supports strong dental and overall health. However, talk to your diabetes care team, as targets may vary.

Find your smile team! Visit the dentist every six months or more often if needed. Check-ups can catch problems early and prevent tooth decay and gum disease.

The good news? Small daily habits make a big difference. Brushing, flossing, and seeing a periodontist protect both your mouth and your body. A healthy mouth supports a healthy life, especially with T1D.

Any guide? You can refer to this guide on how to prepare for your dental appointment (D. Antoniszczak & Periodontitis-Diabetes Hub, n.d.)

Remember: Small steps matter. With consistency and awareness, you can keep your smile bright and your health on track for the long run.