As a result of the current Federal government funding situation, the information on this website may not be up to date or acted upon. Updates regarding government operating status and resumption of normal operations can be found at www.opm.gov . Despite the lapse in appropriations, IHS will continue to provide direct clinical health care services as well as referrals for contracted services that cannot be provided through IHS clinics. For more information on how IHS is impacted, visit: HHS Contingency Plan
Diabetes Standards of Care & Clinical Practice Resources
People with diabetes frequently have problems with their teeth and gums, especially when they have poor glycemic control. The higher the blood glucose, the greater the risk for developing periodontal disease. American Indian and Alaska Native (AI/AN) people with diabetes have two to three times more advanced periodontal disease than people who do not have diabetes.
Oral Care Sections
Quickly jump to a section on this page by clicking on one of the links below.
- Section 1 – Clinical Practice Recommendations: Oral Care
- Section 2 – Clinician and Educator Resources: Oral Care
- Section 3 – Patient Education Resources: Oral Care
Clinical Practice Recommendations
Recommendations for Oral Care
- Examine the patient’s mouth as part of routine diabetes care:
- Examine teeth and gums for plaque, gingival inflammation, and caries.
- Inquire about pain and look for problems, including sores, swollen or bleeding gums, loose teeth, mouth ulcers or growths, candidiasis, or decayed teeth.
- If a patient uses oral tobacco, be sure to examine gums and oral mucosa, especially where the patient usually places the tobacco.
- Refer for professional dental care:
- Annually for routine dental examination.
- More often for people with periodontal disease as determined by the dental care professional.
- As needed for evaluation of oral health problems.
Periodontal disease can result in the loss of some or all teeth in people with diabetes. People without teeth can suffer emotionally and nutritionally because they may not be able to eat many important types of foods. Every attempt should be made to replace missing teeth with dental prosthetics when there is significant loss of chewing function.
Periodontitis can negatively affect diabetes control and development of diabetes complications. The infection and inflammation associated with periodontitis can aggravate blood glucose control and increase risk for many of the complications of diabetes such as cardiovascular disease and chronic kidney disease.
In addition to periodontal disease, other oral health issues observed in people with diabetes include: dental caries, burning mouth syndrome and potential difficulty in wearing dental prosthetics, salivary gland dysfunction/dry mouth, fungal infections, lichen planus and lichenoid reactions, delayed healing, and taste disorders.
Clinician and Educator Resources
IHS Division of Diabetes Treatment and Prevention
National Diabetes Education Program