Diabetes mellitus and periodontal diseases: A two way relationship

Diabetes mellitus and periodontits are both highly prevalent chronic inflammatory diseases. Both diseases share the same risk factors and are a significant global health care burden adversely affecting the quality of life. Evidence from various studies have demonstrated that diabetes is a major risk factor for periodontal disease and is associated with increased incidence, prevalence and severity of periodontal disease. Hyperglycemia associated with diabetes mellitus results in an increased host immunoinflammatory response which adversely affects the periodontal health. Conversely, periodontits is associated with poor metabolic control in patients with diabetes and increased development of diabetic complications suggesting a bidirectional relationship between the two diseases. Periodontal infection via bacteremia exerts a wide systemic effect by contributing to chronic systemic inflammatory burden worsening diabetic state by increasing insulin resistance. Moreover, studies have demonstrated an improvement in glycemic control following periodontal therapy in prediabetic and diabetic patients with periodontitis.