Diabetes And Periodontal Disease: A Two Way Relation ' A Commentary

ABSTRACT

An association between diabetes and periodontitis hasbeen long suspected and has now been reasonably welldocumented for both type I insulin dependent diabetesmellitus and type II non insulin dependent diabetesmellitus. Diabetes mellitus is a systemic complicationaffecting both the quality and length of life. The interrelationshipbetween periodontitis and diabetes provides anexample of systemic disease predisposing to oral infectionand once the infection is established, the oral infection canexacerbate the systemic disease. Diabetes induced changesin immune functions which provide an inflammatory cellphenotype. This predisposes to chronic inflammation,progressive tissue break down and diminished tissuerepair capacity. Periodontal tissues frequently manifestthese changes because they are constantly wounded bysubstances emanating from bacterial bio films. The wellinformed dentist has the opportunity to be at the forefrontof diagnosing diabetes. Studies have shown that nonsurgicalperiodontal treatment is associated with improvedglycemic control in type II diabetes mellitus patient.Periodontal treatment should be undertaken along withstandard measures for diabetic control and care. Preventionand control of periodontal disease must be considered anintegral part of diabetes mellitus.KeywordsDiabetes mellitus; periodontitis; non surgical periodontaltherapy; glycemic control