Diabetes mellitus and periodontal disease: a new perspective in care

Turner C

Published on: 2023-12-13

Abstract

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 higher. However, many doctors are not aware of this.

DM and PD are bidirectionally linked, with 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 treated.

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 progressive periodontitis.

Doctors and dentists and their teams need to share results. A system of red, amber, and green for both medical and dental risks is proposed and pro forma designed so that diabetics themselves can share them with their professional advisors until such times as there are reliable methods of interprofessional communication and a paradigm shift in working practices is achieved.

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.