Your teeth are covered with plaque, a sticky film of bacteria. After you have a meal, snack or beverage that contains sugars or starches, the bacteria release acids derived from dietary sugars that attack tooth enamel. Repeated attacks can cause the enamel to break down and may eventually result in cavities.

When diabetes is not controlled properly, high glucose levels in saliva may help bacteria thrive. Brushing twice a day with fluoride toothpaste and cleaning once a day between your teeth with floss or an inter-dental cleaner helps remove decay-causing plaque. Plaque that is not removed can eventually harden (calcify) into calculus, or tartar. When tartar collects above the gumline, it becomes more difficult to thoroughly brush and clean between teeth. This can create conditions that lead to chronic inflammation and infection in the mouth.

The most common oral health problems associated with diabetes are:

• Dry mouth. Uncontrolled diabetes can decrease saliva flow, resulting in dry mouth. Dry mouth can further lead to soreness, ulcers, infections, and tooth decay.

• Gum inflammation. Besides impairing white blood cells, another complication of diabetes is that it causes blood vessels to thicken, which slows the flow of nutrients to and waste products from body tissues, including the mouth. When this combination of events happens, the body’s ability to fight infections is reduced. Since periodontal disease is a bacterial infection, diabetics with uncontrolled disease may experience more frequent and more severe gum disease.

• Poor healing of oral tissues. People with uncontrolled diabetes do not heal quickly after oral surgery or other dental procedures because blood flow to the treatment site can be impaired.

• Thrush. People with diabetes who frequently take antibiotics to fight various infections are especially prone to developing a fungal infection of the mouth and tongue. The fungus thrives on the high levels of sugar in the saliva of people with uncontrolled diabetes.

• Burning mouth and/or tongue. This condition is caused by the presence of thrush.

As with any condition, good oral hygiene, including regular brushing, flossing and rinsing, as well as the proper diabetic diet, will go a long way in preventing needless problems.