Interrelationship between Diabetes and Periodontitis- A Review

Abstract

Evidence for the link between periodontal disease and several systemic diseases is growing rapidly. Diabetes mellitus is a systemic disease with several major complications affecting both the quality and length of life causing morbidity and mortality. Periodontitis, one of these complications, is a chronic infection associated with substantial morbidity in the form of tooth loss and that affects the quality of life directly. The association between diabetes and inflammatory periodontal disease has been studied extensively. The relationship between these two conditions appears bidirectional. The presence of one condition tends to promote the other and the meticulous management of either may assist treatment of the other. It also provides a perfect example of a cyclical association, whereby a systemic disease predisposes the individual to oral infections, and once the oral infection is established, it exacerbates the systemic disease. This review focuses to explain the interrelationship between the two based on information in the literature and the potential common immunoregulatory connections involved, exploring the mechanisms through which periodontal infection can contribute to the low-grade general inflammation associated with diabetes. Keywords: Diabetes mellitus; inflammation; insulin resistance; periodontitis.

Status of Tobacco Smoking and Diabetes with Periodontal Disease

“…Inadequately controlled diabetes cause a severe breakdown of periodontal tissues. [6][7][8][9] Also, the periodontal disease rate in type 2 DM was three times than in nondiabetic individuals. 5,8 There is sufficient evidence to support the bi-directional relationship between DM and periodontal disease.…”

“…Patients with undiagnosed or poorly controlled DM type 1 or type 2 are at higher risk for periodontal disease. 7,16 Twenty five years ago, Loe had stated periodontitis to be the sixth complications of DM. 5 LOA and bone loss start early in the diabetic population.…”

“…5 Individuals with diabetes are more likely to have periodontal disease than without it. [6][7][8][9] Research has for long, suggested a two-way relationship between DM and periodontal diseases. 6,8 In this context we aim to assess the prevalence of periodontal disease in dental patients in relation to smoking and diabetes…”

Epidemiologic relationship between periodontitis and type 2 diabetes mellitus

“…T2DM and PD have a bidirectional relationship which is well documented in quantities of reviews and epidemiological studies [7][8][9]. PD is defined as the sixth complication of DM, which means DM can promote the progression of PD [10].…”

Oral Health and General Health Connections - An Emerging Challenge

“…It has been reported that chronic release of tumor necrosis factor alpha and other cytokines such as those associated with periodontitis interferes with the action of insulin and leads to metabolic alteration. 5 A review article on the interrelationship between periodontitis and diabetes in this issue has explained the association between oral health and systemic disease. 6…”