JIDAM
SHORT COMMUNICATION
eISSN 2582 - 0559
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THE PERIO-DIABETES NEXUS
Dr. Dhana Divya.K, Dr. Vijayalakshmi. R*,
Department of Periodontology,
Faculty of Dental Sciences,
Sri Ramachandra Institute of Higher Education and Research (Deemed to be University),
Porur, Chennai, Tamil Nadu, India.
* Faculty of Dental Sciences,
Meenakshi Academy of Higher Education and Research Institute, Alapakkam main road, Chennai,
Tamilnadu, India.
To access & cite this article
ABSTRACT
Website: jidam.idamadras.com
The oral cavity is the gateway to our
human system. Whenever the concern
regarding the wellness of the general health
is mentioned, most often the oral health
is overlooked. Scientific evidence over
the years has consistently shown the link
between periodontal diseases and its impact
on the system. Among this perio medicine
interface, the increase in prevalence of both
Address for Correspondence:
periodontal disease and diabetes mellitus
has become an issue of global concern.
Thus, awareness has to be contrived among
Dr. K. Dhana Divya
health care professionals to treat patients in
Senior Lecturer, Faculty of Dental Sciences,
an effective manner to achieve overall health
Sri Ramachandra Institute of Higher Education and
and well-being.
KEYWORDS: Periodontitis, periodontal
Research (Deemed to be University),
medicine, diabetes mellitus
No.1 Ramachandra Nagar, Porur,
Chennai - 600 116,Tamil Nadu, India.
e-mail : k.dhanadivya@sriramachandra.edu.in
Received
: 14.08.2019
Accepted
: 16.09.2019
Published
: 27.10.2019
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JIDAM/Volume:6/Issue:3/Pages 114 - 116/July-September 2019
Divya et al : The Perio-Diabetes Nexus
INTRODUCTION:
greater periodontal destruction; but many studies
have now revealed that periodontal disease leads
Oral health is a window to our overall health
to poor glycaemic control. In a diabetic patient,
and wellbeing. It can serve as a favourable vantage
though periodontal pathogens dominate, most of the
point for detecting the early signs and symptoms
damage to the periodontium occurs by exaggerated
of systemic diseases. The effect of systemic
host response and the formation of AGE (Advanced
conditions on the periodontium is well established.
Glycation Endproducts) which brings about increased
Nowadays, the influence of periodontal diseases
capillary thickening and thus poor wound healing.3
on numerous systemic diseases or conditions like
Whereas, in a periodontitis patient, the excess
cardiovascular disease, preterm low birth weight
production of inflammatory mediators leads to
infants, cerebrovascular disease, diabetes mellitus,
increased insulin resistance, which is of concern.
respiratory infections, osteoporosis and stress is of
Thus, it was predicted that a two-way relation exists
abounding concern. This emerging stream in the field
between the two.
of Periodontology is known as periodontal medicine.
Of all the above-mentioned conditions, diabetes
DISCUSSION :
mellitus has been extensively researched and proven
to have a two-way relationship. The International
The metabolic defects that contribute to the
Diabetes Federation has predicted that India would
development of type II diabetes mellitus include an
be leading in diabetes prevalence in the world by
inefficiency of islet β cells to recoup for high glucose
2030. Therefore, it is important to know the ways
levels that are associated with exorbitant food intake,
and means by which even the smallest chances of
increased glucagon secretion, impaired expansion of
diabetes could be prevented.
subcutaneous adipose tissue, inflammation of adipose
tissue, elevated endogenous glucose production and
PERIODONTITIS AND DIABETES :
the development of peripheral insulin resistance.4
Chronic periodontitis is an inflammatory
Research has put forth that diabetes is a
disease which is mainly caused by periodontal
risk factor for periodontal disease, because it has
pathogens. The presence and accumulation of
significant impact on the bone in periodontal diseases.
bacterial biofilm may cause an irreversible damage
Mealey et al in his study concluded that diabetic
to the underlying connective tissue and further
patients had a three-fold higher risk of periodontal
destruction of the supporting bone. Although the
disease compared with non-diabetic patients after
bacteria are initiating agents in periodontitis, the
adjusting for age, sex and other confounding factors.5
host response to the pathogens is crucial for the
Diabetes mellitus as discussed earlier is a systemic
progression of disease. Apart from this, numerous
disease associated with conditions that may affect the
risk factors influence the severity, progression of the
quality of life. There can be damage to the nervous
disease and response to therapy.
system, retina, cardiovascular and renal systems.
Apart from these secondary complications, research
Type II diabetes mellitus is a complex
done by Philstrom et al has shown an increased risk of
metabolic disorder that is characterized by chronic
periodontal disease or its greater severity in diabetic
hyperglycemia and altered lipid metabolism.1
patients.6 Apart from this, studies on Pima Indians in
The primary abnormality is either reduced insulin
Arizona by Shlossman M et al7 showed greater loss
production or impaired insulin action or a combination
of periodontal attachment and bone loss in diabetics
of both.
compared to non-diabetic individuals within different
age groups, thereby suggesting a possible underlying
The relationship between periodontitis and
mechanism between the two.
diabetes mellitus has been extensively investigated
over the past few decades and periodontitis has been
Evidence for improvement in glycemic
considered as the sixth complication of diabetes
levels after periodontal treatment comes from
2
mellitus.
Randomised Controlled Trials
(RCT), one such
trial was conducted in 1997 by Grossi et al8, who
Diabetes affects oral tissues and brings about
showed that periodontal therapy when combined
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JIDAM/Volume:6/Issue:3/Pages 114 - 116/July-September 2019
Divya et al : The Perio-Diabetes Nexus
with systemic antibiotics reduced HbA1c levels in
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CONCLUSION :
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This bidirectional nexus of periodontitis
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relevance not only to patients seen in our dental office
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diabetes mellitus and other systemic diseases.
FINANCIAL SUPPORT AND
SPONSORSHIP:
Nil
CONFLICTS OF INTEREST:
There are no conflicts of interest.
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