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.
Highlights
Diabetes mellitus (DM) covers a group of metabolic diseases characterized by hyperglycaemia caused by defects in insulin secretion, insulin action, or both
Current scientific evidence points to a two-way relationship between diabetes mellitus (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
Periodontal diseases have not been “officially” recognized as a complication of DM, the scientific evidence available indicates that poor metabolic control may increase the risk of gingivitis and periodontitis [2]; these periodontal pathologies have been associated with diverse systemic diseases closely related to DM, such as cardiovascular diseases, obesity and metabolic syndrome [3] [4]
Summary
Diabetes mellitus (DM) covers a group of metabolic diseases characterized by hyperglycaemia caused by defects in insulin secretion, insulin action, or both. DM is a major healthcare concern because of its high prevalence and the enormous social and healthcare costs it incurs. Another important aspect of this disease is the high morbidity and mortality it produces. This article reviews and updates current understanding of the complex relationship between DM and inflammatory periodontal diseases, focusing on the following aspects: the role of DM as a risk factor for periodontal diseases; the effect of periodontal infections on diabetic complications and the incidence DM; the mechanisms linking these entities; the effect of periodontal therapy on glycemic control in patients with DM; the implications of this association for health-care professionals
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