Gum Disease and General Health: Diabetes, Heart Disease and Pregnancy
Gum disease is linked with diabetes, heart disease, problems in pregnancy and other conditions, but the links differ in strength, and a link does not prove that one condition causes another. This page gives the evidence for each, the inflammation that may explain them, and what it means.
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Clinically reviewed by Dr Ibraheem Ijaz, dentist · GDC 301711
Medical disclaimer: This page is for general information only. It does not replace an examination or treatment by a dentist.
Dr Ibraheem Ijaz, GDC 301711, a General Dental Practitioner and the principal dentist at Deepcar Dental Care, reviewed this page. His qualifications include BDS, BSc (Hons) and MSc (Leeds).
How is gum disease linked to general health?
UK guidance links oral and general health both ways: some health conditions raise gum disease risk, and active gum disease carries risks for general health.
Delivering Better Oral Health (DBOH), the UK prevention toolkit, says diabetes and cardiovascular diseases share some genetic or environmental influences with gum disease, so people may show signs of either condition or both.
How could gum inflammation affect the rest of the body?
Consensus reports describe oral bacteria entering the blood, and inflammation, as mechanisms that may explain these oral-systemic associations.
In the 2020 report of the European Federation of Periodontology (EFP) and the World Heart Federation, oral bacteria entered the bloodstream after everyday activities such as toothbrushing and chewing and after dental procedures, more often in people with periodontitis, though some studies had methodological limits. People with periodontitis also had higher blood levels of C-reactive protein (CRP), an inflammation marker.
Our periodontitis page explains the gum disease that destroys the tooth's attachment.
How are gum disease and diabetes linked?
Gum disease and diabetes are linked both ways: high blood sugar raises gum disease risk, and active gum disease can hinder blood sugar control.
DBOH lists raised blood sugar as a risk factor for gum disease. Well-controlled diabetes is not one, it says, but because control often varies, it advises assuming a higher risk for anyone with diabetes. Leeds Teaching Hospitals NHS Trust gives the reverse: active gum disease can make diabetes more difficult to control.
The 2018 consensus of the International Diabetes Federation and the EFP found strong evidence that people with periodontitis have a higher risk of raised blood sugar (dysglycaemia) and insulin resistance. It also associates periodontitis with a higher risk of developing type 2 diabetes.
Does treating gum disease improve blood sugar control?
In people with both periodontitis and diabetes, a 2022 Cochrane review reported moderate-certainty evidence that treatment below the gum line improves glycaemic (blood sugar) control by a clinically significant amount, compared with no treatment or usual care.
All but one of the review's 35 trials (3,249 people) studied type 2 diabetes only, and most took place in secondary care. Against the comparison groups, HbA1c, a blood sugar measure, was 0.43% lower 3 to 4 months after treatment (30 trials), 0.30% lower at 6 months (12 trials) and 0.50% lower at 12 months (one trial). Trials that measured harms generally reported none or only mild ones, but most trials did not assess them.
Is gum disease linked to heart disease?
Studies link gum disease with heart disease, but have not shown that gum disease causes it or that treating gum disease prevents it.
The EFP and World Heart Federation report found robust epidemiological evidence of an association between periodontitis and coronary heart disease, and evidence of an association with cerebrovascular disease and stroke, with risk estimates varying between studies.
The American Heart Association's 2012 statement concluded that observational studies support an association between gum disease and atherosclerotic vascular disease, independent of known confounders, but not a causal relationship.
A 2022 Cochrane review found only two treatment trials, both at high risk of bias. In people with periodontitis and metabolic syndrome, very low-certainty evidence on deep cleaning plus antibiotics versus cleaning above the gum line was inconclusive for preventing a first cardiovascular event, and a rise in events could not be excluded. No reliable trial evidence covered people who already have cardiovascular disease.
Questions about this treatment? Book online or call the practice.
Is gum disease linked to problems in pregnancy?
Periodontitis in pregnancy has been associated with premature birth, low birthweight and pre-eclampsia, but treatment trials have not shown a clear fall in premature births.
The 2013 consensus of the EFP and the American Academy of Periodontology describes the associations with adverse pregnancy outcomes as modest, apparently varying with the population studied and how gum disease was assessed and classified. It identified two possible pathways: oral bacteria or their components reaching the placenta and baby, or circulating inflammatory signals affecting them.
A 2017 Cochrane review of 15 trials, all at high risk of bias, found no clear difference in births before 37 weeks between gum treatment in pregnancy and no treatment (low-quality evidence). Low-quality evidence suggested it may reduce low birthweight (under 2,500 g), with limited confidence in that estimate, and effects on births before 35 or 32 weeks, perinatal death and pre-eclampsia were unclear.
Our pregnancy and gum health page covers gum changes in pregnancy.
What other conditions have been linked with gum disease?
Links with rheumatoid arthritis and lung conditions are uncertain: DBOH says there is insufficient information to determine the true relationship between rheumatoid arthritis and periodontitis.
A 2026 umbrella review of 14 meta-analyses suggested a statistical association between periodontitis and most of the respiratory diseases studied, which were COVID-19, chronic obstructive pulmonary disease (COPD), asthma and pneumonia. Its certainty was low, the COPD link may not be independent of smoking, and the authors called the results exploratory and hypothesis-generating rather than definitive.
What does this mean for you?
NHS guidance recommends regular dental check-ups, especially if you are pregnant or have type 2 diabetes.
If you have diabetes, Leeds Teaching Hospitals suggests talking to your dentist or doctor about any concerns about diabetes and gum disease, and for type 2 diabetes the NHS advises going to all your diabetes appointments.
If you have cardiovascular disease or are at risk of it, the EFP and World Heart Federation advise telling your dentist your cardiovascular history, medicine changes and any anticoagulants (blood thinners) you take, and keeping up regular dental and medical visits.
When should you see a dentist about your gums?
NHS guidance gives these actions; if you do not have a dentist or cannot get an emergency appointment, call 111 or visit 111 online:
- Gums that bleed when you brush your teeth or eat hard foods, gums that are painful and swollen, bad breath, or a child with sore, bleeding gums: see a dentist.
- Gum disease, in you or your child, with other symptoms such as very sore and swollen gums, teeth becoming loose or falling out, ulcers or red patches in your mouth, or a lump in your mouth or on your lip: ask for an urgent dentist appointment.
- Toothache that lasts more than 2 days, does not go away with painkillers, or comes with a high temperature, pain when you bite, red gums, a bad taste or a swollen cheek or jaw: see a dentist.
- Toothache with swelling around your eye or neck, or swelling in your mouth or neck that makes it difficult to breathe, swallow or speak: go to A&E, but do not drive; ask someone to drive you or call 999 and ask for an ambulance.
How much does gum disease treatment cost?
Non-surgical periodontal therapy and treatment of advanced gum disease have no line on the practice's current fee list. Ask us about the cost.
Frequently asked questions
Is gum treatment safe during pregnancy?
Gum treatment in pregnancy has been shown to be safe and to improve gum health, a 2013 European and American consensus found. It said treatment did not reduce overall rates of premature birth or low birthweight. In a 2017 Cochrane review, no maternal deaths or adverse effects of treatment occurred in the trials that reported them.
Does treating gum disease reduce inflammation in the body?
In short-term studies, yes. The American Heart Association found that gum treatment reduced systemic inflammation and dysfunction of the blood vessel lining, and the EFP and World Heart Federation report links treatment with lower C-reactive protein. The heart association found no evidence that it prevents artery disease or changes its outcomes.
Does diabetes affect how well gum treatment works?
It can. DBOH says raised blood sugar impairs the response to gum disease treatment, and Leeds Teaching Hospitals says poorly controlled diabetes can make gum disease progress faster and treatment more difficult. Tobacco also impairs the treatment response, DBOH adds, and our smoking and gum disease page covers it.
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Deepcar Dental Care is at 334 Manchester Road, Deepcar, Sheffield, S36 2RH, with free parking directly outside. Our page on periodontal disease explains how it develops, our hygiene appointments page covers professional hygiene visits, and our patient reviews show what patients say.
334 Manchester Road
Deepcar, Sheffield S36 2RH
0114 288 2121
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