Determining the antibacterial substantivity of Triphala mouthwash and comparing it with 0.2% chlorhexidine gluconate after a single oral rinse: A crossover clinical trial.

CONTEXT: Triphala has been extensively used in dentistry as a mouthwash because of its antiplaque and antigingivitis properties. AIM: The present study is designed to determine the duration of its antibacterial substantivity after a single oral rinse and to compare it with the substantivity of 0.2% chlorhexidine gluconate (CHX). MATERIALS AND METHODS: In this clinical crossover trial, unstimulated saliva from 30 individuals was collected 2 h after routine oral hygiene procedures but not rinsing (pre-sample) with randomly selected mouthwash, (10% Triphala mouthwash, 0.2% CHX, and normal saline) and 5 min after rinsing (postsample). A washout period of 1 week was kept between two rinses. The sampling was repeated after every 2 h for 12 h (post 1, post 2, post 3, post 4, post 5, and post 6) and was checked for microbial count. STATISTICAL ANALYSIS USED: Friedman test, Kruskal-Wallis test, and post hoc analysis were used to assess the effect of different mouthrinses on colony forming units at different times. RESULTS: Ten percent Triphala showed statistically significant results when the antibacterial effect at post, post 1 and post 2 were compared to pre-assessment count (P < 0.05). After which the effect was at par with normal saline (P > 0.05). The results for CHX were statistically significant at all times when compared to pre-assessment count (P < 0.05) and it showed the maximum substantivity of 7 h. CONCLUSION: After a single rinse with no eating and drinking restrictions over the day, 10% Triphala mouthwash had an antibacterial effect for 3-4 h. It can be used three times daily for its maximum antibacterial effect.

Management of diabolical diabetes mellitus and periodontitis nexus: Are we doing enough?

Periodontitis is the commonest oral disease affecting population worldwide. This disease is notorious for the devastation of tooth supporting structures, ensuing in the loss of dentition. The etiology for this disease is bacterial biofilm, which accumulates on the teeth as dental plaque. In addition to the biofilm microorganisms, other factors such as environmental, systemic and genetic are also responsible in progression of periodontitis. Diabetes mellitus (DM) is metabolic disorder which has an impact on the global health. DM plays a crucial role in the pathogenesis of periodontitis. Periodontitis is declared as the "sixth" major complication of DM. Evidence based literature has depicted an enhanced incidence and severity of periodontitis in subjects with DM. A "two way" relationship has been purported between periodontitis and DM. Mutual management of both conditions is necessary. Periodontal therapy (PT) may assist to diminish the progression of DM and improve glycemic control. Various advanced technological facilities may be utilized for the purpose of patient education and disease management. The present paper clarifies the etio-pathogenesis of periodontitis, establishing it as a complication of DM and elaborating the various mechanisms involved in the pathogenesis. The role of PT in amelioration of DM and application of digital communication will be discussed. Overall, it is judicious to create an increased patient cognizance of the periodontitis-DM relationship. Conjunctive efforts must be undertaken by the medical and oral health care professionals for the management of periodontitis affected DM patients.

Duloxetine Hydrochloride-Induced Oral Lichenoid Reaction: A Case Report.

OBJECTIVE: To report the first case of duloxetine hydrochloride (DH)-induced oral lichenoid drug reaction (OLDR). CLINICAL PRESENTATION AND INTERVENTION: A 57-year-old male patient presented with painful ulcerative lesions on the bilateral buccal mucosa of 2-year duration. The patient was on multiple drug therapy for his systemic ailments. After thorough evaluation for possible medical ailments and with the physician's consent, withdrawal of DH was done. The oral lesions were resolved after 2 weeks. CONCLUSION: In this case, DH induced OLDR.

Treatment of a large periradicular defect using guided tissue regeneration: A case report of 2 years follow-up and surgical re-entry.

Periradicular (PR) bone defects are common sequelae of chronic endodontic lesions. Sometimes, conventional root canal therapy is not adequate for complete resolution of the lesion. PR surgeries may be warranted in such selected cases. PR surgery provides a ready access for the removal of pathologic tissue from the periapical region, assisting in healing. Recently, the regeneration of the destroyed PR tissues has gained more attention rather than repair. In order to promote regeneration after apical surgery, the principle of guided tissue regeneration (GTR) has proved to be useful. This case presents the management of a large PR lesion in a 42-year-old male subject. The PR lesion associated with 21, 11 and 12 was treated using GTR membrane, fixated with titanium minipins. The case was followed up for 2 years radiographically, and a surgical re-entry confirmed the re-establishment of the lost labial plate. Thus, the principle of GTR may immensely improve the clinical outcome and prognosis of an endodontically involved tooth with a large PR defect.

Efficacy of High-volume Evacuator in Aerosol Reduction: Truth or Myth? A Clinical and Microbiological Study.

Background and aims. Basic periodontal treatment aims at eliminating supra- and sub-gingival plaque and establishing conditions which will allow effective self-performed plaque control. This aim is primarily achieved with sonic and ultrasonic scalers. However, generation of bacterial aerosols during these procedures is of great concern to patients, the dentist and the dental assistant. The aim of this study was to compare the reduction in aerosol with and without high-volume evacuator through a microbiological study. Materials and methods. For this clinical study a fumigated closed operatory was selected. Maxillary incisors and canines were selected as an area for scaling. Piezoelectric ultrasonic scaling was performed in the absence and in the presence of a high-volume evacuator at 12 and 20 inches from the patient's oral cavity. In both groups scaling was carried out for 10 minutes. Nutrient agar plates were exposed for a total of 20 minutes. After this procedure, nutrient agar plates were incubated in an incubator at 37°C for 24 hours. The next day the nutrient agar plates were examined for colony forming units by a single microbiologist. Results. The results showed no statistically significant differences in colony forming units (CFU) with and without the use of a high-volume evacuator either at 12 or 20 inches from the patient's oral cavity. Conclusion. It was concluded that high-volume evacuator, when used as a separate unit without any modification, is not effective in reducing aerosol counts and environmental contamination.

The implication of periodontitis in vascular endothelial dysfunction.

BACKGROUND: Periodontitis is the most common oral infection seen in humans worldwide. It is characterized by gradual destruction of tooth supporting tissues, eventually leading to loss of tooth. The periodontal biofilm associated with periodontitis comprises of gram-positive and gram-negative bacteria, instrumental for the initiation and progression of periodontitis. Evidence-based literature has identified the nature of periodontal infection as a possible causative condition in the inducement of 'low-grade systemic inflammation and infection'. The periodontal pathogens exert systemic effects via the haematogenous route. AIM: The present review provides an insight into the pathophysiology of the endothelial dysfunction with reference to periodontal infection and highlights the association between periodontitis and endothelial dysfunction. Various studies addressing the implication of periodontitis on endothelial dysfunction will be described, with a focus of periodontal treatment on improvement of endothelial function. MATERIALS AND METHODS: Studies examining the effects of periodontitis on vascular endothelial function were segregated. Studies conducted on both animal and human models were identified using MEDLINE database search with key search terms such as 'Periodontitis', 'vascular endothelium', 'endothelial dysfunction', 'periodontal bacteria' and 'periodontal therapy'. Systematic reviews and meta-analysis were also screened. Only studies published in English language were considered. The review has been prepared by screening MEDLINE database from 1989 to 2012. RESULTS AND CONCLUSIONS: Chronic periodontitis results in altered vascular response, increased expression of pro-inflammatory cytokines and adhesion molecules inducing vascular endothelial dysfunction. Periodontal therapy may ameliorate the perturbed vascular endothelial function.

A randomized clinical trial to evaluate and compare the efficacy of triphala mouthwash with 0.2% chlorhexidine in hospitalized patients with periodontal diseases.

PURPOSE: Triphala is a combination of three medicinal plants, extensively used in Ayurveda since ancient times. Triphala mouthwash is used in the treatment of periodontal diseases because of its antimicrobial and antioxidant properties. The aim of this study is to compare the efficacy of triphala mouthwash with 0.2% chlorhexidine in hospitalized periodontal disease patients. METHODS: In this double-blind, randomized, multicenter clinical trial, 120 patients were equally divided into three groups. Patients in group A were advised to rinse their mouths with 10 mL of distilled water, group B with 0.2% chlorhexidine, and group C with triphala mouthwash for 1 minute twice daily for two weeks. The plaque index (PI) and the gingival index (GI) were recorded on the first and the fifteenth day. RESULTS: There was no significant difference when the efficacy of triphala was compared with 0.2% chlorhexidine in hospitalized patients with periodontal disease. However, a statistically significant difference was observed in PI and GI when both group B and group C were compared with group A and also within groups B and C, after 15 days (P<0.05). CONCLUSIONS: The triphala mouthwash (herbal) is an effective antiplaque agent like 0.2% chlorhexidine. It is significantly useful in reducing plaque accumulation and gingival inflammation, thereby controlling periodontal diseases in every patient. It is also cost effective, easily available, and well tolerable with no reported side effects.

Alzheimer's disease and periodontitis--an elusive link.

Alzheimer's disease is the preeminent cause and commonest form of dementia. It is clinically characterized by a progressive descent in the cognitive function, which commences with deterioration in memory. The exact etiology and pathophysiologic mechanism of Alzheimer's disease is still not fully understood. However it is hypothesized that, neuroinflammation plays a critical role in the pathogenesis of Alzheimer's disease. Alzheimer's disease is marked by salient inflammatory features, characterized by microglial activation and escalation in the levels of pro-inflammatory cytokines in the affected regions. Studies have suggested a probable role of systemic infection conducing to inflammatory status of the central nervous system. Periodontitis is common oral infection affiliated with gram negative, anaerobic bacteria, capable of orchestrating localized and systemic infections in the subject. Periodontitis is known to elicit a "low grade systemic inflammation" by release of pro-inflammatory cytokines into systemic circulation. This review elucidates the possible role of periodontitis in exacerbating Alzheimer's disease. Periodontitis may bear the potential to affect the onset and progression of Alzheimer's disease. Periodontitis shares the two important features of Alzheimer's disease namely oxidative damage and inflammation, which are exhibited in the brain pathology of Alzheimer's disease. Periodontitis can be treated and hence it is a modifiable risk factor for Alzheimer's disease.

The association of periodontitis and metabolic syndrome.

Metabolic syndrome (MS) is a condition, which constitutes a group of risk factors that occur together and increase the risk for Coronary Artery Disease, Stroke and type 2 diabetes mellitus. This disorder is found prevalent in the industrialized societies of the world in epidemic proportions. Periodontitis is an oral disease of microbial origin characterized by loss of attachment apparatus of tooth, resulting in edentulism if untreated. Periodontitis has been attributed to produce a low grade systemic inflammatory condition. The link of periodontitis to various systemic disorders has led to the evolution of a new branch termed as "periodontal medicine." Studies reviewed in the present paper have indicated a positive link between the MS and periodontitis and it is suggested that subjects displaying several components of MS should be submitted to periodontal examination. Present studies have displayed coherent relation between the two entities. This review will address the vicious association between MS and periodontitis, depicting the commonality of pathophysiological pathway between the two entities. Systematic reviews, meta-analysis addressing the concerned subject were screened. Whether the systematic periodontal therapy in individuals exhibiting MS has the potential to reduce the incidence of various adverse systemic complications remains a logical proposition. Further, longitudinal and controlled trials with a large population would be imperative to depict the robustness in the association between MS and periodontal disease in human subjects.

Herbal anti-inflammatory immunomodulators as host modulators in chronic periodontitis patients: a randomised, double-blind, placebo-controlled, clinical trial.

PURPOSE: Host modulatory therapy has been proposed as a treatment for periodontal diseases. A class of herbal medicines, known to be immunomodulators, alters the activity of immune function through the regulation of informational molecules such as cytokines. In the current study, we tested the hypothesis that herbal immunomodulator drugs act as an adjuvant to scaling and root planing (SRP) in alleviating periodontal inflammation by improving clinical and biochemical parameters. METHODS: Sixty healthy subjects (30 in each group) with moderate and severe chronic periodontitis were enrolled in a double-blind, placebo-controlled, double-masked randomised controlled trial. The control group was treated with SRP and a placebo, whereas the test group was treated with SRP followed by dietary supplementation of Septilin for 3 weeks. Periodontal clinical parameters and serum C-reactive protein (CRP) levels were evaluated for all patients at the baseline, 3 weeks, and 6 weeks. RESULTS: Improved gingival index scores found in the test group as compared to the control group were found to be statistically significant only after 3 weeks (P<0.001). In contrast, the decrease in the sulcus bleeding index and pocket depth scores was statistically highly significant in the test group as compared to the control group after 3 weeks and 6 weeks (P<0.001). However, reduced clinical attachment level and CRP scores, as reflected in the test group as compared to the control group, were not found to be statistically significant after both 3 weeks (P>0.05) and 6 weeks (P>0.05). CONCLUSIONS: The results of this clinical-biochemical study suggest that dietary supplementation with herbal immunomodulatory agents may be a promising adjunct to SRP and may aid in improving periodontal treatment outcomes.

Omega 3 fatty acids as a host modulator in chronic periodontitis patients: a randomised, double-blind, palcebo-controlled, clinical trial.

PURPOSE: Periodontitis is an infectious disease caused predominantly by gram-negative anerobes. The host inflammatory response to these bacteria causes alveolar bone loss that is characterized as periodontitis. Omega-3 fatty acids (ω-3 FAs) have anti-inflammatory properties, thus have been used to treat some chronic inflammatory diseases such as cardiovascular disease and rheumatoid arthritis. We aimed to evaluate the effect of dietary supplementation with ω-3 FAs as a host modulating agent in patients with chronic periodontitis. METHODS: Sixty otherwise healthy subjects with moderate and severe chronic periodontitis were enrolled in our randomised, double-blind, placebo-controlled trial. The control group (CG, n=30) was treated with scaling and root planing (SRP) and given a placebo; the treatment group (TG, n=30) was treated with SRP and dietary supplementation of ω-3 FAs (one 300 mg tablet daily for 12 weeks). Periodontal clinical parameters and serum C-reactive protein (CRP) levels were evaluated in all patients at baseline, a 6-week and 12-week period after treatment. RESULTS: A significant reduction in the gingival index, sulcus bleeding index, pocket depth, and clinical attachment level was found in the TG compared to the CG at a 12-week period. However, no statistically significant changes in serum CRP levels were found. CONCLUSIONS: Our findings suggest that ω-3 FAs can successfully reduce gingival inflammation, pocket depth, and attachment level gain. Dietary supplementation with ω-3 FAs may have potential benefits as a host modulatory agent in the prevention and/or adjunctive management of chronic periodontitis.

Sclerotherapy: a novel bloodless approach to treat recurrent oral pyogenic granuloma associated with port-wine stain.

Pyogenic granuloma (PG) is a commonly occurring nonneoplastic inflammatory lesion in the oral cavity. Recent reports have demonstrated a rare association between skin PG and port-wine stain (PWS). Various treatment modalities such as complete excision, curettage, cryotherapy, chemical and electric cauterizations, lasers, and intralesional corticosteroids have been used to treat the lesion. In this case report, we present a novel method for the treatment of recurrent PG in a woman with concurrent presentation of PWS. In this patient, sclerotherapy with sodium tetradecyl sulfate (STS) was used as a treatment modality with successful resolution of the lesion. The authors thus conclude that sclerotherapy with STS can be an effective alternative for the treatment of recurrent PG associated with PWS.

Alzheimer's disease and periodontitis - an elusive link / A doença de Alzheimer e periodontite - um esquivo link

Alzheimer's disease is the preeminent cause and commonest form of dementia. It is clinically characterized by a progressive descent in the cognitive function, which commences with deterioration in memory. The exact etiology and pathophysiologic mechanism of Alzheimer's disease is still not fully understood. However it is hypothesized that, neuroinflammation plays a critical role in the pathogenesis of Alzheimer's disease. Alzheimer's disease is marked by salient inflammatory features, characterized by microglial activation and escalation in the levels of pro-inflammatory cytokines in the affected regions. Studies have suggested a probable role of systemic infection conducing to inflammatory status of the central nervous system. Periodontitis is common oral infection affiliated with gram negative, anaerobic bacteria, capable of orchestrating localized and systemic infections in the subject. Periodontitis is known to elicit a "low grade systemic inflammation" by release of pro-inflammatory cytokines into systemic circulation. This review elucidates the possible role of periodontitis in exacerbating Alzheimer's disease. Periodontitis may bear the potential to affect the onset and progression of Alzheimer's disease. Periodontitis shares the two important features of Alzheimer's disease namely oxidative damage and inflammation, which are exhibited in the brain pathology of Alzheimer's disease. Periodontitis can be treated and hence it is a modifiable risk factor for Alzheimer's disease.

A doença de Alzheimer é uma proeminente causa e a forma mais comum de demência. Caracteriza-se clinicamente por uma progressiva diminuição da função cognitiva, que tem início com a deterioração da memória. A exata etiologia e o mecanismo fisiopatológico da doença de Alzheimer ainda não são totalmente compreendidos. No entanto, postula-se que a neuroinflamação desempenhe um papel crucial na patogênese da doença de Alzheimer. A doença de Alzheimer é caracterizada por importantes características inflamatórias, assinalada pela ativação microglial e escalada dos níveis de citocinas pró-inflamatórias nas regiões afetadas. Estudos têm sugerido um provável papel de infecção sistêmica imbuída de estado inflamatório do sistema nervoso central. Periodontite é uma infecção oral comum associada a germes Gram-negativos, anaeróbios, capaz de orquestrar infecções localizadas e sistêmicas no paciente. É conhecida por suscitar um "baixo grau de inflamação sistêmica" pela liberação de citocinas pró-inflamatórias na circulação sistêmica. Esta revisão elucida o possível papel da periodontite no agravamento da doença de Alzheimer e pode ter o potencial de afetar o início e a progressão da doença de Alzheimer. Periodontite partilha as duas importantes características da doença de Alzheimer: dano oxidativo e inflamação, que estão presentes na patologia do cérebro com doença de Alzheimer. Periodontite pode ser tratada e, portanto, é um fator de risco modificável para a doença de Alzheimer.

Platelet rich fibrin: a new hope for regeneration in aggressive periodontitis patients: report of two cases.

The purpose of this study was to evaluate the effectiveness of platelet rich fibrin (PRF) in periodontal regeneration in generalized aggressive periodontitis (GAgP) patients. Two patients diagnosed with GAgP were selected for this study. Baseline clinical and radiographic examination was performed and patients were treated by surgical periodontal therapy along with PRF. Post-surgical re-evaluation was carried out at regular intervals to evaluate clinical and radiographic changes. Surgical periodontal therapy accompanying the placement of PRF in angular defects of GAgP patients showed decreased probing pocket depth, increased attachment level and radiographic bone fill when baseline and 9 month follow-up data was compared. Surgical reconstructive therapy with placement of PRF in angular defects of GAgP patients can be an effective approach to enhance the periodontal regeneration.

Advanced glycation end products: a link between periodontitis and diabetes mellitus?

Advanced glycation end products (AGEs) are synthesized via the non enzymaticglycation and oxidation of proteins, lipids and nucleic acids. The production of AGEs is particularly enhanced in chronic hyperglycemia, as in diabetes mellitus (DM). The formation of irreversible AGEs affects the tissues by compromising the physiologic and mechanical functions, as a result of defective constitution of the extracellular matrix (ECM) components. Periodontitis is an inflammatory disease of microbial origin, resulting in devastation of the tooth supporting apparatus. This disease condition has severe implicationsin subjects with DM, since the tooth supporting tissuescontain ECM targeted by AGE. There is miniscule literature regarding the contribution of AGE to periodontal disease in patients with DM. The purpose of this review is to address the prejudicial role of AGEs in relation to various tissue components. This paper is an attempt to elucidatethe possible link of AGEs between periodontitis and DM. The exploration of novel therapeutic strategies to target AGEs for the treatment of periodontitis in DM subjects is certainly intriguing.

Effect of scaling and root planing combined with systemic doxycycline therapy on glycemic control in diabetes mellitus subjects with chronic generalized periodontitis: a clinical study.

PURPOSE: The purpose of study was to compare glycemic control using glycated hemoglobin levels (HbA1c) in diabetic patients with chronic generalized periodontitis (CGP) undergoing scaling and root planing (SRP) with and without systemic doxycycline. METHODS: Fifty subjects with type 2 diabetes mellitus (T2DM) and CGP receiving antidiabetic therapy were selected for study. The selected subjects were randomly assigned to two groups (test group [TG] and control group [CG]) comprising 25 patients each. The TG received SRP followed by systemic doxycycline. The CG received treatment with SRP only. The periodontal parameters were recorded at baseline (day zero), and every 1 month for 4 months and included probing depth, clinical attachment level, plaque index, gingival index, and HbA1c level were recorded at baseline (day zero) and at the end of 4 months. RESULTS: A statistically significant effect was demonstrated for the periodontal parameters for both the TG and CG. HbA1c values did not show a statistically significant difference in the treatment group as compared to the CG. CONCLUSIONS: The authors concluded that nonsurgical periodontal therapy improved glycemic control in patients with T2DM in both groups, but no statistical difference was observed with adjunctive systemic doxycycline therapy. A further study with a larger sample size is required.

Screening for diabetes mellitus using gingival crevicular blood with the help of a self-monitoring device.

PURPOSE: The purpose of study was to compare blood glucose in capillary finger-prick blood and gingival crevice blood using a self-monitoring blood glucose device among patients with gingivitis or periodontitis. METHODS: Thirty patients with gingivitis or periodontitis and bleeding on probing (BOP) were chosen. The following clinical periodontal parameters were noted: probing depth, BOP, gingival bleeding index, and periodontal disease index. Blood samples were collected from gingival crevicular blood (GCB) and capillary finger-prick blood (CFB). These samples were analyzed using a glucose self-monitoring device. RESULTS: Descriptive statistical analysis has been carried out in the present study. Data were analyzed using a Pearson's correlation coefficient and Student's t-test. A r-value of 0.97 shows very strong correlation between CFB and GCB, which was statistically highly significant (P<0.0001). CONCLUSIONS: The authors conclude that GCB may serve as potential source of screening blood glucose during routine periodontal examination in populations with an unknown history of diabetes mellitus.

Periodontal therapy -- an adjuvant for glycemic control.

AIMS: Periodontitis is an oral infection affecting the tooth- supporting tissues. Although the prime etiology for this condition is bacterial plaque, the host immune response also has substantial contribution to the destruction of the periodontal apparatus. Periodontitis elicits a "low grade systemic inflammation". Diabetes mellitus is intricately related to the development, progression and severity of periodontitis. The literature is abundant with studies depicting this association. Periodontal therapy (PT) involves removal of bacterial component leading to the resolution of clinical signs and symptoms of disease. This review aims to create awareness amongst the medical professionals regarding the two-way relationship between diabetes and periodontitis, emphasizing on the positive effects of PT. MATERIAL AND METHODS: Studies addressing the effects of PT on glycemic control in type 2 Diabetes (T2DM) subjects were identified using PubMed search with key search terms such as "Glycemic control", "Periodontitis", "Periodontal therapy", "Type 2 diabetes mellitus". The review has been prepared by screening PUBMED database from January 1990 to March 2012. RESULTS: PT bears an unexplored potential and can serve as an adjuvant to the conventional treatment for diabetes. CONCLUSION: A major conclusion of this review is that PT instituted in type 2 diabetic human subjects assists in amelioration of the inflammatory biomarker levels and glycemic status. There is a wide scope for further studies to highlight the beneficial effects of PT in diabetic subjects and the dire need for periodontal screening of these individuals for glycemic maintenance.

Periodontitis and insulin resistance: casual or causal relationship?

Insulin resistance (IR) is now considered as a chronic and low level inflammatory condition. It is closely related to altered glucose tolerance, hypertriglyceridemia, abdominal obesity, and coronary heart disease. IR is accompanied by the increase in the levels of inflammatory cytokines like interleukin-1 and 6, tumor necrosis factor-α. These inflammatory cytokines also play a crucial part in pathogenesis and progression of insulin resistance. Periodontitis is the commonest of oral diseases, affecting tooth investing tissues. Pro-inflammatory cytokines are released in the disease process of periodontitis. Periodontitis can be attributed with exacerbation of IR. Data in the literature supports a "two way relationship" between diabetes and periodontitis. Periodontitis is asymptomatic in the initial stages of disease process and it often escapes diagnosis. This review presents the blurred nexus between periodontitis and IR, underlining the pathophysiology of the insidious link. The knowledge of the association between periodontitis and IR can be valuable in planning effectual treatment modalities for subjects with altered glucose homeostasis and diabetics. Presently, the studies supporting this association are miniscule. Further studies are mandatory to substantiate the role of periodontitis in the deterioration of IR.

Periodontitis and risk of diabetes mellitus.

Diabetes mellitus (DM) is a complex disease with varying degrees of systemic and oral complications. The periodontium is also a target for diabetic damage. Diabetes is a pandemic in both developed and developing countries. In recent years, a link between periodontitis and diabetes mellitus has been postulated. The oral cavity serves as a continuous source of infectious agents that could further worsen the diabetic status of the patient and serve as an important risk factor deterioration of diabetes mellitus. The present review highlights the relationship between diabetes mellitus and periodontitis. The potential mechanisms involved in the deterioration of diabetic status and periodontal disease are also discussed.