One for All™: How to Tackle with Diabetes, Obesity and Periodontal Diseases

Abstract

Diabetes, obesity, and oral diseases (dental caries and periodontal diseases), largely preventable chronic diseases, are described as global pandemic due their distribution and severe consequences. 1-4 WHO calls for a global action for prevention and promotion regarding these diseases as a vital investment in urgent need. 1-4 Current scientific evidence provides a strong and plausible basis to assert that diabetes, obesity and oral diseases have common risk factors (poor dietary habits, a sugar-rich diet, smoking) 5-9 and biologic mechanisms. 10-17 Current research supports that there is a bidirectional relationship between type 2 diabetes (DM2) and oral health: Poor oral health negatively contributes to glycemic control whereas poor DM2 management negatively affects oral health. 17 Thus, they lead to poor systemic health conditions. 18 Obesity is a triggering risk factor both for DM2 and oral diseases, namely periodontal diseases. 10-12 Diabetes and obesity, showing an increasing trend, lead to disabilities and negatively affect the quality of life through life-course along with oral diseases. 19, 20 WHO projects that there are almost 200 million people with diabetes at present, and 3,2 million deaths/year are attributable to diabetes complications, and both will double worldwide by 2030. 19,21-23 Globally, more than 1 billion adults are overweight; almost 300 million of them are clinically obese. Being obese or overweight raises steeply the likelihood of developing DM2; approximately 85% of people with diabetes are DM2, and of these 90% are obese or overweight. 22 Promoting a good oral health is significantly essential for preventing and reducing the negative consequences of DM2 and obesity. 24 Key to successful maintenance of a high glycemic control, DM2 management and obesity, and good oral health is adherence to the regime of daily treatment and self-care practices. 25-28 However, many patients find or feel themselves unable to follow recommended lifestyles (a healthy diet, physical exercise, no smoking, medications, twice daily toothbrushing), which makes them more prone to diabetes-related complications, poor oral health and obesity; therefore leading a poor quality of life. WHO, 2 International Diabetes Federation (IDF), 29 The World Dental Federation (FDI), 30 and Council of European Dentists, 31 American Dental Association 32 underline a need to adopt a common-risk factor approach 33 for oral and general health promotion; a need for interventions integrating oral health into chronic disease management. WHO highly recommends behavioral interventions to meet this need. 34