The influence of periodontal disease on glycemic control in diabetes

Periodontitis is a chronic inflammatory condition that is initiated by bacteria and results in the destruction of the tissues that anchor and support the teeth in the oral cavity. Individuals with diabetes mellitus are at high risk for periodontitis. Moreover, the current thinking about the relationship between these two disease entities is that it is bi-directional. Not only does diabetes mellitus negatively impact periodontal status, but periodontitis also adversely affects glycemic control and other outcomes in diabetic patients. This chapter summarizes the evidence that explores the potential effects of periodontitis on the diabetic state, including glycemic control, development of complications, and incident diabetes, and briefly describes possible mechanisms that lend biologic plausibility to this aspect of the association between the two diseases.