Relationship between diabetes and periodontal disease

The human body is a complex system where everything is connected. Although it may seem surprising, periodontal disease is deeply linked to other ailments outside the mouth. Studies have shown a link between periodontal disease and other conditions such as heart disease, stroke, and pathology. However, one of the most relevant relationships it has is with diabetes. Although the mechanism linking these two conditions is not fully understood, it is proven that there is a bidirectional relationship between them. In this article, we will talk about periodontal disease, diabetes and the relationship between them.

Periodontal disease

It is defined as a metabolic disorder characterized by elevated blood sugar levels or hyperglycemia. Also, it is divided into two types:

Diabetes

Periodontitis is one of the most common diseases affecting the world population. It is an inflammatory disease that consists of a microbiological colonization in the subgingival area (between the gums and the tooth), often caused by biofilm and tartar. This leads to loss of bone mass and the formation of pockets in the gums. In addition, the most common symptoms are inflammation, bleeding gums, dental pockets, dental mobility and in advanced stages, tooth loss.

  • Type 1 diabetes: consists of an autoimmune response that leads to the destruction of the insulin-producing β cells in the pancreas. Therefore, it results in the need for insulin injections to compensate for the lack of insulin due to low production.
  • Type 2 diabetes: corresponds to 90% of cases worldwide. This type of diabetes is caused by insulin resistance, which reduces the ability of glucose to be transferred from the bloodstream to cells and causes hyperglycemia.
  • What does blood sugar have to do with periodontal disease?
    Studies have shown that diabetes is directly associated with a higher prevalence and severity of periodontitis. Patients with glucose levels under control have a lower risk of periodontitis complications due to diabetes. However, poor glycemic control exponentially increases the risk and extent of periodontitis by up to 2-3 times. Diabetes also slows the rate of mucosal wound healing, prolonging the time it takes to recover from periodontitis. On the other hand, it is also proven that severe periodontitis is associated with compromised glycemic control. Studies have also shown a higher rate of diabetes complications such as neuropathy and cardiovascular disease in diabetic patients with periodontitis. Furthermore, moderate and severe periodontitis can predict the onset of nephropathy in patients with type 2 diabetes.

How does it work?

The actual mechanism linking the two diseases is not fully understood. However, the most popular hypotheses state that both diseases could share a common or similar origin, leading to susceptibility to the disease on the part of the host or a direct causal relationship in which diabetes triggers an inflammatory reaction in cells. In conclusion, diabetes and periodontitis are common diseases throughout the world. As a diabetic patient, it is vital to understand the relationship between them. Also, since it is usually painless, periodontitis often goes unnoticed. Therefore, regular dental appointments are vital to prevent complications and maintain a healthy life.