A Sweet Smile
Understanding the Relationship of Diabetes &
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
What is the relationship between diabetes and periodontal
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
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
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