Does It Make Sense that Diabetes is Reciprocally Associated with Periodontal Disease?

Abstract

Epidemiological studies indicated that more than 15% of the population in western countries suffer because of severe forms of periodontitis, In this respect, the recognition of the relationship between oral and systemic health is growing, thus receiving remarkable interest in scientific literature. In fact, periodontitis may increase the risk for a group of life-threatening conditions such as atherosclerosis, stroke or low birth weight. The American Diabetes Association has reported that individuals with uncontrolled diabetes (defined as 200mg/dL of glucose on three consecutive readings) undergo an increased risk of infections, abnormal wound healing and consequent increased recovery time. Moreover, diabetics may be more likely to develop periodontal and cardiovascular disease than non diabetics, if note. History of poorly controlled chronic periodontal disease can alter diabetic/glycemic control. This may originate from a likely continuous passege of bacterial toxins and/or bacteria into the bloodstream, and/or from an exaggerated release of inflammatory mediators. This review is aimed at elucidating the connections between the status of oral health and glycemic control in diabetes.

A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes

“…To date, most models proposed to explain the clinical and pathogenic relationships between diabetes and periodontal disease have supported the concept of a '2-way' interaction between these disorders (Grossi & Genco 1998, Mealey & Oates 2006, Santacroce et al 2010, Lalla & Papapanou 2011, Preshaw et al 2012. These models have provided a role for pro-inflammatory mediators (cytokines, AGEs, oxidative stress, etc.)…”

The Effect of Periodontal Treatment on Hemoglobin A1c Levels of Diabetic Patients: A Systematic Review and Meta-Analysis

“…Although strong evidence tends to support the adverse effects of diabetes on periodontitis, numerous reports indicate that periodontitis can adversely affect glycemic control in diabetics [20], [21]. It is considered that this close association between periodontitis and diabetes is established on the reciprocal influence [22].…”

Barriers to Dental Services for Older Adults

“…1 The relationship between oral health and general health is particularly strong among older adults. 2 Many older adults suffer from severe periodontal disease and there is evidence that periodontal disease is associated with cardiovascular disease, [3][4][5][6][7][8][9][10][11][12] poor diabetic control, [13][14][15][16][17][18] and respiratory disease. 19 Furthermore, poor oral health and the loss of teeth are associated with lower intakes of nutrient rich foods and dietary fiber.…”