Diabetes mellitus and periodontal disease: some perspectives in care. A Review

While the incidence of diabetes mellitus varies between populations and countries type 2 is becoming an increasing burden for health care professionals. First recorded in 1928, people living with diabetes mellitus (DM) are at a 3-4 times higher risk of developing periodontal disease (PD) than non-diabetics; for those who smoke this risk is up to 10 times. However, many doctors are not aware of this. DM and PD are bidirectionally linked, the one affecting the other and vice versa, although the mechanism is not fully understood and may be linked to chronic infection. PD has an adverse effect on glycaemic control. That improves when periodontitis is successfully controlled. Doctors should consider PD when their patients have persistently high glycated haemoglobin (HbA1c) levels, and dentists should consider diabetes or pre-diabetes when they have patients with unstable or progessive periodontitis. Wherever possible, for optimum health outcomes doctors and dentists and their teams need to share results and work together. A traffic light system of red, amber and green for both medical and dental risks is proposed, and a pro forma designed, so that diabetics themselves can share their own results with their professional advisors. Dentists need to find ways to teach their medical colleagues about the basics of PD, update their medical records, and understand more about medical risks. More research is required .