Diabetes and periodontitis: multidisciplinary management

Diabetes has reached epidemic levels in North America and continues to rise in prevalence, generating a significant financial burden on society. The strong link between type 2 diabetes and periodontitis provides a sound basis for dental professionals to screen for and help manage diabetic patients. Literature from journals of both medicine and dentistry was included to provide a comprehensive examination of the bi-directional relationship between diabetes and periodontitis. This review highlights the necessity for multidisciplinary management of patients suffering from both disease processes, and the benefits of how treatment of one can positively impact the other. Additional analysis of the precise effect of hyperglycemia on the severity and progression of periodontal disease should be conducted to gain further insight into the relationship between the two diseases. It is incumbent on oral health care providers to become a partner in managing patients with periodontitis and type-2 diabetes. Abbreviations: AGE: advanced glycated end product; BOP: bleeding on probing; CDC: center for disease control; DM: diabetes mellitus; HbA1c: hemoglobin A1c; LPS: lipopolysaccharide; MMP: matrix metalloproteinases; NET: neutrophil extracellular trap; PISA: periodontal inflamed surface area; PD: probing depths; PMN: polymorphonuclear lymphocyte; RAGE: receptor of advanced glycation end product; RANKL: receptor activator of nuclear factor kappa-b ligand; ROS: reactive oxygen species; T2DM: type 2 diabetes mellitus; TNFalpha: tumor necrosis factor-alpha