There exists a definite relationship between diseases of oral cavity especially periodontal infections and systemic diseases. This article discusses the clinical implication of diabetes in periodontics.

Periodontal diseases usually cause tooth loss among adults. These diseases are associated with polymicrobial infections which stimulate inflammatory response in periodontal tissues that result in loss of support of the affected teeth. Most studies indicate that the host response, rather than the direct effect of bacteria is responsible for the process. Bacteria or their products have indirect role in stimulating inflammation which is associated with inflammatory mediators such as prostaglandins, TNFα or interleukin. These mediators in turn induce the production and activation of enzymes that destroy gingival connective tissues and stimulate osteoclasts to cause bone resorption. It is estimated that several million individuals in India have diabetes. Studies have shown that both type I and type II diabetes increase the risk of periodontal diseases and cause severe periodontal breakdown.

It has been repeatedly shown that the risk of periodontal disease is greatly influenced by diabetes, because diabetes has a significant impact on the bone in periodontal diseases. People with this disease need a thorough periodontal evaluation and a special consideration in treatment planning. Treatment of diabetes often reduces the risk of more severe periodontal diseases. It has been reported that effective periodontal treatment helps in the stabilization of serum glucose levels. The commonest periodontal feature in diabetes is increased attachment loss, apical migration of epithelial attachment, formation of periodontal pockets and multiple gingival and periodontal abscesses It has also been reported that in diabetes, bacterial infection causes an enhanced net bone loss.

Diabetes has been considered as an important risk factor for periodontitis. Diabetes is found to increase the risk of developing periodontal disease about three-fold. However, the actual cause of which is not known. Diabetic patients, therefore require utmost care, attention and timely intervention to prevent progression of periodontal disease.

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