Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 25, 2016; 7(4): 50-66
Published online Feb 25, 2016. doi: 10.4239/wjd.v7.i4.50
Management of diabolical diabetes mellitus and periodontitis nexus: Are we doing enough?
Abhijit N Gurav
Abhijit N Gurav, Department of Periodontology, Tatyasaheb Kore Dental College and Research Centre, New Pargaon, Kolhapur 416137, Maharashtra State, India
Author contributions: Gurav AN is the sole contributor to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Abhijit N Gurav, BDS, MDS, Professor, Head of Department of Periodontology, Tatyasaheb Kore Dental College and Research Centre, New Pargaon, NH204 Road, Kolhapur 416137, Maharashtra State, India.
Telephone: +91-230-2477081 Fax: +91-230-2477654
Received: August 10, 2015
Peer-review started: August 10, 2015
First decision: September 28, 2015
Revised: October 16, 2015
Accepted: January 16, 2016
Article in press: January 19, 2016
Published online: February 25, 2016

Periodontitis is the commonest oral disease affecting population worldwide. This disease is notorious for the devastation of tooth supporting structures, ensuing in the loss of dentition. The etiology for this disease is bacterial biofilm, which accumulates on the teeth as dental plaque. In addition to the biofilm microorganisms, other factors such as environmental, systemic and genetic are also responsible in progression of periodontitis. Diabetes mellitus (DM) is metabolic disorder which has an impact on the global health. DM plays a crucial role in the pathogenesis of periodontitis. Periodontitis is declared as the “sixth” major complication of DM. Evidence based literature has depicted an enhanced incidence and severity of periodontitis in subjects with DM. A “two way” relationship has been purported between periodontitis and DM. Mutual management of both conditions is necessary. Periodontal therapy (PT) may assist to diminish the progression of DM and improve glycemic control. Various advanced technological facilities may be utilized for the purpose of patient education and disease management. The present paper clarifies the etio-pathogenesis of periodontitis, establishing it as a complication of DM and elaborating the various mechanisms involved in the pathogenesis. The role of PT in amelioration of DM and application of digital communication will be discussed. Overall, it is judicious to create an increased patient cognizance of the periodontitis-DM relationship. Conjunctive efforts must be undertaken by the medical and oral health care professionals for the management of periodontitis affected DM patients.

Keywords: Cost-effectiveness, Advanced glycation end products, Complications, Glycated hemoglobin, Inflammation, Mobile health, Periodontitis, Periodontal therapy, Scaling and root planing, Type 2 diabetes mellitus

Core tip: Various studies have corroborated a two-way relationship between diabetes mellitus and periodontitis. Periodontal therapy (PT) can assist to ameliorate the glycated hemoglobin levels. Metabolic control in diabetes may prevent further complications. Given the large scale epidemiology of both diabetes and periodontitis, it is prudent for the oral health care personnel to co-ordinate efforts with the diabetes care personnel, for the mutual management of these conditions. The implication of PT in metabolic control of diabetes and the various methods for the systematic management of diabetes-periodontitis nexus are explained in this review.