Interrelation between Diabetes Mellitus and Periodontal Disease

The purpose of this chapter is to present scientific evidence for the links between Periodontitis and diabetes with a focus on potential common pathophysiologic pathways including those associated with inflammation, altered host responses and insulin resistance. The pathogenesis of periodontal disease is complex because it reflects a combination of the initiation and maintenance of the chronic inflammatory process by a diverse microbial flora and its numerous bacterial products. The interrelation between diabetes mellitus and inflammatory periodontal disease has been intensively studied for more than 50 years. It seems that there is a reciprocal relationship between these two illnesses: one tends to exacerbate the other, and treating one with care can help treat the other. This relationship is largely mediated by inflammation, which is responsible for the pathogeny and consequences of diabetes mellitus as well as periodontal disease. Conversely, periodontal infection can seriously impair the metabolic control of some diabetic patients. Moreover, treatment of periodontal disease and reduction of oral signs of inflammation may have a beneficial effect on diabetes. Further research is needed to clarify how inflammatory periodontal diseases may affect insulin resistance, glycemic control and the risk of developing other diabetic complications.