A Sweet Smile

Understanding the Relationship of Diabetes &
Periodontal Diseases

Periodontal diseases include Gingivitis (in which the inflammation is confined to the gingiva, and is reversible with good oral hygiene) and Periodontitis (in which the inflammation extends and results in tissue destruction and alveolar bone resorption). Tissue destruction in Periodontitis results in breakdown of the collagen fibres of the periodontal ligament, resulting in the formation of a periodontal pocket between the gingiva and the tooth.

Periodontitis is a slowly progressing disease but the tissue destruction that occurs is largely irreversible. In the early stages, the condition is typically asymptomatic; it is not usually painful, and many patients are unaware until the condition has progressed enough to result in tooth mobility.

What is the relationship between diabetes and periodontal diseases?

Diabetes has been identified as a major risk factor for Periodontitis. In the early 1990s Periodontitis was referred to as the ‘sixth complication of diabetes’. Not only is diabetes a risk factor for Periodontitis, but Periodontitis could have a negative effect on glycaemic control. Several studies suggest that periodontal infection is associated with an increased risk of poor glycaemic control suggesting that severe periodontitis is a risk factor for compromised diabetes management.

What are the pathogenic mechanisms linking Diabetes and Periodontitis?

Inflammation is a central feature of the pathogenesis of Diabetes and Periodontitis. The elevated inflammatory state in Diabetes contributes to both microvascular and macrovascular complications. It is clear that hyperglycemia can result in the activation of pathways that increase inflammation, oxidative stress and apoptosis.

What are some ‘good to know facts’ about diabetes and periodontal diseases?

Patients with poorly controlled diabetes must be considered at risk for periodontal diseases and should be made aware of it. Early diagnosis and prevention can intercept irreversible loss of bone, therefore early referral of adults to dental clinicians for periodontal screening is recommended. Periodontal therapy in patients have resulted in a much better glycaemic control, hence oral hygiene should be promoted in patients with Diabetes as an integral component of their overall Diabetes management.

Dr. Malini Thomas

Dr. Malini Thomas

Consultant Periodontist
& Oral Implantologist
Nanavati Super Speciality
Hospital, Mumbai