Periodontitis as early detection of diabetes mellitus: a literature review

Abstract

Background: Diabetes mellitus (DM) is a growing health problem and its prevalence is dramatically increasing, particularly in Indonesia. It can affect every organ in the body, and one of the oral manifestations is periodontitis characterized by the loss of tissue attachment. This review aims to identify further the periodontitis as early detection of diabetes mellitusMethods: A review of relevant literature was performed to elaborate on periodontitis involvement in diabetes mellitus. A total of 25 qualified published literature of all years were collected from several electronic database and manual search and included in this review.Results: On average, patients with periodontitis showed higher glycated haemoglobin (HbA1c) plasma levels compared with individuals without periodontitis. Diabetes and periodontitis are complex chronic diseases with an established bidirectional relationship. There is long-established evidence that hyperglycemia in diabetes is associated with adverse periodontal outcomes. Here, we show that periodontitis is an early sign of diabetes mellitus and may, therefore, serve as a valuable risk indicator. A dentist who got patient with periodontitis is a suitable location for screening for diabetes by a simple finger stick and validated HbA1c dry spot analysis.Conclusion: Literature from a different type of study concluded that periodontitis is one of the oral manifestations that could be used as early detection in diabetes mellitus

Differences in levels of bone morphogenetic protein-2 in periodontitis patients with and without type 2 diabetes mellitus

“…It was reported that periodontal infection can impair glycemic control by increasing tissue insulin resistance. 4,7 The results of this study revealed that bone morphogenetic protein-2 (BMP-2) levels in the periodontitis group with type 2 DM were significantly lower compared to the BMP-2 levels in the periodontitis group without type 2 DM. This may indicate that type 2 DM was likely to trigger more severe periodontal tissue damage.…”

“…Diabetic microangiopathy, impaired immune response, and lower resistance to infection may contribute to the development of periodontitis in uncontrolled diabetics. 4 Hyperglycemia can cause indirect damage through the end result of glucose products, that is advanced glycation end products (AGEs) mediated by RANKL, and direct cell damage from stimulation of intracellular pathways. Advanced glycation end products (AGEs) cause an increase in matrix metalloproteinases (MMPs) and a decrease in collagen synthesis resulting in collagen degradation.…”

“…Because the periodontium has a highly vascular tissue, any inflammation can serve as a gateway to the systemic circulation for bacterial products and inflammatory mediators. 4 Longitudinal studies have shown that the severity of periodontitis is associated with poorly controlled glycemia, higher HbA1c levels, and the development of systemic diabetes complications. Periodontitis is associated with a slight increase in HbA1c in non-diabetic subjects (periodontitis has the potential to increase the incidence of diabetes), although a clear association has not been established.…”

“…3 Periodontitis can occur in all age groups (adults, children and adolescents) but most often found in adult population. 4 Increasing risk factors of periodontal disease include smoking, diabetes mellitus (DM), HIV/AIDS, family history, and certain medications. Periodontitis in people with diabetes mellitus is called diabetic periodontitis.…”