Diabetes and Oral Health: A Hidden Connection That Many Patients Don't Know About
New Research Reveals Alarming Gaps in Knowledge Among Type 2 Diabetes Patients in Gaza
The Silent Oral Health Crisis Among Diabetics
When we think about diabetes complications, most people immediately picture heart disease, kidney problems, or vision loss. But there's another part of the body that diabetes quietly attacks—and it's hiding in plain sight: your mouth.
A new study published in BMC Oral Health has uncovered a troubling reality. While most type 2 diabetes patients know they're at risk for oral health problems, very few actually practice proper dental care. The research, conducted among 376 patients in Gaza Strip, Palestine, paints a concerning picture of the gap between awareness and action.
What the Researchers Did
A team led by Aymen Elsous from Israa University designed a comprehensive mixed-method study combining surveys with in-depth interviews. Between May and November 2022, they recruited patients from five primary health centers across Gaza's governorates.
The quantitative portion used questionnaires based on the Health Belief Model a framework that examines how people perceive health threats and the benefits of taking preventive action. Meanwhile, 13 patients participated in face-to-face interviews to share their personal experiences with dental care.
The Numbers Tell a Story
The findings reveal a paradox. On one hand, awareness exists: roughly 64% of patients acknowledged their susceptibility to oral health problems, and 68% recognized these complications as serious. An impressive 73% believed that good oral hygiene practices would benefit them.
Yet here's where it gets troubling. Only 42.5% of participants actually maintained adequate oral health habits. While 58% brushed twice daily, only 32% visited a dentist for regular checkups. Most strikingly, nearly 80% had never received any education about oral care from their healthcare providers.
The consequences were evident. Almost 80% reported experiencing oral problems in the past year, with tooth decay (58%) and tooth loss (53%) being the most common complaints.
Barriers That Block Better Care
When asked what prevents them from maintaining good oral health, patients pointed to several obstacles. The biggest? Cost. Over 70% said they simply couldn't afford dental check-ups.
But financial constraints weren't the only problem. More than half admitted to fearing the dentist's chair, while 55% felt they lacked adequate knowledge about proper dental hygiene procedures.
The qualitative interviews painted an even more vivid picture. Patients described government dental clinics as offering little beyond tooth extraction. Root canals, restorations, and scaling essential services for diabetics were unavailable. Some patients reported being turned away because clinics had run out of basic supplies like gloves.
"When you want to do restoration, they said it is finished. When you want root canal treatment, they said it doesn't exist. They just do tooth extraction," shared one 47-year-old male participant from Gaza.
A Communication Breakdown
Perhaps most concerning was the disconnect between patients and dental professionals. Many interviewees expressed frustration that dentists rarely asked about their blood sugar levels or explained how diabetes affects oral health.
"They didn't give me any information," was a common refrain. Patients reported that doctors at primary health centers never referred them to dentists or inquired about their oral health status.
Without formal education programs at health facilities, patients turned to television, the internet, and neighbors for information sources that may be inaccurate or misleading.
Why This Matters
The relationship between diabetes and oral health runs both ways. Poor blood sugar control increases the risk of gum disease, while untreated periodontal infections can make it harder to manage blood glucose levels. This bidirectional relationship means neglecting oral health can create a vicious cycle that worsens overall diabetes outcomes.
The study population faced additional challenges. Over 83% lived below the poverty line, 62% had uncontrolled diabetes (HbA1c above 7%), and nearly three-quarters were unemployed. These socioeconomic factors compound the difficulties in accessing proper dental care.
Moving Forward: Policy Recommendations
The researchers propose several actionable solutions. They advocate for integrating oral health assessments into routine diabetes care protocols, launching culturally appropriate educational campaigns, and expanding insurance coverage or subsidies for dental services among diabetic patients.
They also emphasize the need for better collaboration between medical and dental professionals, along with quality assurance standards that include patient satisfaction and diabetes-specific care protocols.
The Bottom Line
This study highlights a critical but often overlooked aspect of diabetes management. While most patients understand they're at risk for oral complications, significant barriers financial, educational, and systemic revent them from taking action. Addressing these gaps requires coordinated efforts from healthcare providers, policymakers, and communities alike.
As one 63-year-old female participant from Gaza wisely noted: "I went to check my teeth because I know the effect of diabetic disease on my oral health." That awareness needs to become the norm, not the exception.
Original Article Reference:
Elsous, A., Fetaiha, A., & Radwan, M. (2025). Exploring oral health related awareness, perceptions, practices and experiences among type 2 diabetes mellitus patients: a mixed method design. BMC Oral Health, 25, 781.
DOI: https://doi.org/10.1186/s12903-025-06153-5