Some elderly people with diabetes cannot control their blood glucose well after taking blood glucose lowering medications, and even after switching to multiple medications or strictly controlling their diet, their blood glucose is still high. Why is this? New medical research has shown that oral hygiene is one of the reasons affecting blood glucose levels in diabetes. Older diabetics have varying degrees of gingivitis and periodontitis. In the past, diabetes was thought to be an important factor in triggering gingivitis and periodontitis, but recent medical research has confirmed that diabetes and oral inflammation are causally related, and that oral inflammation may also trigger diabetes. There are hundreds of species of bacteria in the mouth, some of which can produce toxins. When these toxins enter the bloodstream, they make the islet receptors on the surface of the body’s cells insensitive, meaning that the insulin in the blood does not work as well on the cells anymore. This is because insulin can only work if it binds to the insulin receptors on the surface of the cells. And insulin receptors cannot bind to insulin, giving the endocrine nervous system the false impression that insulin is not working, when in fact it is the body’s cells that are resistant to insulin, leading to an increase in blood sugar. In diabetic patients with oral inflammation, especially with septic inflammation, blood glucose tends to be elevated and is more difficult to control within the normal range. If a patient’s blood sugar is not well controlled, it is worthwhile to check the mouth to eliminate inflammation of the gums and periodontium. Dental cleanings (scaling) are usually performed every six months to effectively remove harmful bacteria from the mouth.