Diabetes and periodontal disease: a two way relation – a commentary

Abstract

An association between diabetes and periodontitis has been long suspected and has now been reasonably well documented for both type I insulin dependent diabetes mellitus and type II non insulin dependent diabetes mellitus. Diabetes mellitus is a systemic complication affecting both the quality and length of life. The inter-relationship between periodontitis and diabetes provides an example of systemic disease predisposing to oral infection and once the infection is established, the oral infection can exacerbate the systemic disease. Diabetes induced changes in immune functions which provide an inflammatory cell phenotype. This predisposes to chronic inflammation, progressive tissue break down and diminished tissue repair capacity. Periodontal tissues frequently manifest these changes because they are constantly wounded by substances emanating from bacterial bio films. The well informed dentist has the opportunity to be at the forefront of diagnosing diabetes. Studies have shown that non-surgical periodontal treatment is associated with improved glycemic control in type II diabetes mellitus patient. Periodontal treatment should be undertaken along with standard measures for diabetic control and care. Prevention and control of periodontal disease must be considered an integral part of diabetes mellitus.