Dentistry & Type 1 Diabetes: Tips for Strong Smiles

🦷 Dentistry & Type 1 Diabetes: Sweet Tooth Tips for Strong Smiles

The longer I practice dentistry—and live with Type 1 Diabetes—the more I’m struck by how beautifully connected everything is. What started as a personal diagnosis during dental school has turned into a lifelong journey of learning how deeply oral health and whole-body health intertwine. It’s been humbling, eye-opening, and honestly, kind of awe-inspiring.

As a pediatric dentist and someone managing T1D myself, I think often about how even small daily habits can shape our health in big ways. The mouth truly is the gateway to the rest of the body, influencing everything from digestion and inflammation to heart health and blood sugar control.

With over 41 known factors affecting cavity risk—including diet, genetics, saliva pH, and hygiene—it’s clear there’s no one-size-fits-all approach. T1D is just one important piece of the puzzle when it comes to understanding a person’s full health picture.

In this post, I’m sharing some of my favorite oral health tips—especially for families navigating Type 1 Diabetes. I hope they’re helpful, doable, and maybe even a little fun!

Dr. Niekia Franklin is a pediatric dentist living with T1D. You can listen to her recent episode of the Juicebox Podcast here.

🪥 Daily Habits for a Healthy Smile

1. Floss Daily

Flossing removes plaque from 40% of tooth surfaces that brushing can’t reach. Hug each tooth like a squeegee!
Kids need help until age 10.
✅ Why it matters for T1D: Diabetes significantly increases the risk of gum disease. Kids with T1D experience 35–57% more bleeding around teeth. Gum inflammation increases systemic inflammation, worsens insulin resistance, and raises the risk of heart disease and stroke.

2. Brush Twice a Day for 2 Minutes

Focus on gum lines, chewing surfaces, and molars. Use an electric toothbrush when tolerated, and choose a toothpaste with fluoride or hydroxyapatite.
Kids usually need help until at least age 7.
✅ Why it matters for T1D: Sticky plaque combined with dry mouth makes the mouth more acidic and cavity-prone. Plaque will start to harden after 24 hours and can turn into tartar which cannot be cleaned off at home and contributes to gum inflammation.

3. Tongue Scraping

Gently scraping your tongue each morning helps remove bacteria, freshen breath, and support a healthy oral microbiome.
✅ Why it matters for T1D: Fungal overgrowth is more common—scraping helps reduce the risk.

🫁 Breathing & Development

4. Encourage Nasal Breathing

Nasal breathing supports proper jaw growth, reduces dry mouth, and promotes better sleep and focus.
✅ Why it matters for T1D: Nasal breathing helps reduce mouth dryness and supports cardiovascular and sleep health.

5. Watch for Signs of Sleep-Disordered Breathing

Signs include snoring, mouth breathing, teeth grinding, restless sleep, enlarged tonsils, and symptoms like ADHD. Use tools like the Fairest 6 and Pediatric Sleep Questionnaire as at-home screening resources.
✅ Why it matters for T1D: Poor sleep impacts hormones, attention, school performance, and blood sugar regulation.

6. Stop Non-Nutritive Sucking Early

Pacifiers and thumb-sucking should ideally stop by age 1–1.5 to avoid lasting jaw changes.
✅ Why it matters: Prolonged habits can increase the need for braces—braces can make hygiene harder and raise cavity risk.

🥕 Nutrition & Snacking Smarts

7. Eat Nutrient-Dense, Microbiome-Loving Foods

Prioritize fish, meat, veggies, and fermented foods like kefir, unsweetened yogurt, and sauerkraut.
✅ Why it matters: Nutrients like vitamins A, D, E, K2, and calcium support tooth and bone health, balance the microbiome, and won’t spike blood sugar.

8. Limit Sticky, Processed Snacks

Avoid crackers, gummy vitamins, dried fruit, and other sticky carbs that cling to teeth. If eating stickier carbs,  pairing  with cheese, crunchy veggies, water, or following with xylitol gum to neutralize acids.
✅ Why it matters for T1D: Frequent snacking on carbs contributes to both cavity formation and blood sugar challenges.

9. Hydrate, Hydrate, Hydrate

Water all day, milk with meals, and ideally no more than one sweet drink daily. *if not for blood sugar management.
✅ Why it matters for T1D: T1D kids often produce less saliva and have higher salivary glucose—both increase cavity risk.  Milk has natural sugars that can contribute to cavities. Juice is missing the fruit fiber and tends to cause a rapid rise in blood sugar in addition to being a lot of sugar and acid.

🦷 Prevention & Dental Visits

10. Start Dental Visits Early & Stay Consistent

The first visit should be by age 1 or when the first tooth erupts.
Preventive options like sealants, silver diamine fluoride, and Curodont can stop cavities in their tracks.
✅ Why it matters for T1D: Regular visits catch small problems early, avoiding larger treatments that carry higher risks for kids with T1D.

💬 Final Thoughts

A few small habits can go a long way in protecting your child’s smile—and their overall wellness. There are unique oral health connections that come with Type 1 Diabetes, and I hope all families feel confident asking questions and finding the support they need.

Everything shared here is based on my experience and current research. Please talk with your healthcare providers about what’s best for your child’s specific needs.

💌 Have a tip that’s helped your family? I’d love to hear it!
📧 doc@redwoodpediatricdentist.com

📚 Sources & Further Reading

1. Oral Health Implications and Dental Management of Diabetic Children – Davidopoulou et al., PMC9973101

2. International Journal of Clinical Pediatric Dentistry, 2022 – DOI: 10.5005/jp-journals-10005-2426

3. Flossing May Reduce Risk for Stroke and Irregular Heart Rhythm – American Heart Association

🔗 Helpful Resources

• 🦷 Dentist Dad Snack Guide – Tooth-friendly snack ideas for busy families

• 😴 Pediatric Sleep Questionnaire (UC Davis) – A helpful screening tool for sleep-disordered breathing

• 🛏️ Fairest 6 Tool – At-home checklist for airway and sleep health