Diabetes and Periodontal Diseases: An Established Two-Way Relationship

Abstract

Background: Periodontal diseases (PD), including periodontitis, are chronic inflammatory pathologies caused by bacteria in the subgingival biofilm which affect the periodontal tissues. PD is now considered a localized, chronic, oral infection that activates the host immuno-inflammatory responses both locally and systemically, and also constitutes a source of bacteraemia. It is a known fact that periodontal diseases exercise an important influence on the pathogenesis of numerous systemic diseases, including diabetes mellitus (DM). In the mid-nineties, sufficient scientific evidence emerged to confirm an association between DM and periodontitis, which then began to be regarded as the sixth complication of DM. Current scientific evidence points to a two-way relationship between DM and periodontal disease, whereby DM is associated with an increase in the incidence and progression of periodontitis, while periodontal infection is associated with worsening glycemic control in diabetic patients. This two-way relationship points to a need to promote oral health in DM patients, and to implement a joint management protocol between endocrinologist and dentist that aims to create adequate conditions for early diagnosis and the effective treatment of both diseases.

Periodontal Disease in Patients with Type 2 Diabetes and Its Relationship with Dry Mouth Condition

“…Mann-Whitney test was used to compare the means of periodontal parameters between the www.dental.usm.my/aos/ original article | Periodontal disease in type 2 diabetic patients with dry mouth condition 81 Saliva is an important fluid in the oral cavity; one of its many functions is to clear the oral cavity of bacteria, which could potentially harm the periodontium. Many studies have shown that DM and periodontal disease are biologically linked together (Preshaw et al, 2012;Casanova et al, 2014;Molina et al, 2016). Moreover, xerostomia and salivary gland hypofunction have also been reported in DM subjects (Chávez et al, 2000;Chávez et al, 2001;Moore et al, 2001;Bajaj et al, 2012), which could be more damaging to the periodontium.…”

“…Over time, these collagen fibres accumulate in the tissues and thickened the basement membrane, a condition which could impair oxygen diffusion, waste elimination, leukocyte migration, and the diffusion of immune factors. These disorders would then contribute to the pathogenesis of periodontitis (Lalla et al, 1998;Molina et al, 2016).…”

A Comparison between Type-2 Diabetics and Non-Diabetics in Terms of Papillary Bleeding Index (PBI)

“…5 Diabetes mellitus is considered to be one of the important factors involved in promoting the risk for the diseases of oral periodontium 15 . Molina et al, reported that almost every parameter of periodontal disease is adversely affected by diabetes 16 . In the present study, the factors like age; gender, socioeconomic status, education level and frequency of oral hygiene measures were matched between the groups (Table 1, Figure 1).…”

Frecuencia de enfermedad periodontal en pacientes adultos con diabetes mellitus tipo 2 en la Ciudad Autónoma de Buenos Aires y la Provincia de Buenos Aires

“…Por lo explicado anteriormente, la EP se consideraría un factor de riesgo en la patogénesis de numerosas enfermedades sistémicas, incluida la DM [9][10][11][12] .…”