Authors
Manikandan GR1, Ajithkumar KC1
1Department of Periodontics, Government Dental College, Trivandrum
Abstract
Background: Diabetes mellitus and chronic periodontitis are highly prevalent chronic diseases with a well-established bidirectional relationship. Periodontitis is more common and severe in diabetic patients, and in turn, periodontal infection can negatively impact glycemic control.
Objectives: This review aims to explore the complex two-way interrelationship between diabetes mellitus and periodontal disease, detailing how each condition influences the other and discussing current management approaches.
Methods: This article synthesizes findings from clinical observations, experimental studies, epidemiological research, and meta-analyses to describe the associations, underlying biological mechanisms, and therapeutic implications of this relationship.
Results: Evidence consistently demonstrates increased periodontal disease prevalence and severity in individuals with diabetes, particularly those with poor glycemic control. Diabetes exaggerates the host inflammatory response to periodontal pathogens, leading to greater tissue destruction. Conversely, periodontal infections contribute to systemic inflammation, elevating markers like C-reactive protein (CRP) and interleukins (IL-6, TNF-α), which promote insulin resistance and worsen metabolic control. The “two-hit” model highlights how systemic diseases like diabetes can exacerbate localized periodontal inflammation. Periodontal therapy has been shown to improve glycemic control in diabetic patients.
Conclusion: The intricate interplay between diabetes and periodontal disease underscores the importance of integrated medical and dental care. Effective periodontal management is crucial for diabetic patients, not only for oral health but also for improving systemic glycemic control and reducing the overall inflammatory burden.