Periodontal disease: associations with diabetes, glycemic control and complications.
OBJECTIVE
This report reviews the evidence for adverse effects of diabetes on periodontal health and periodontal disease on glycemic control and complications of diabetes.


METHODS
MEDLINE search of the English language literature identified primary research reports published on (a) relationships between diabetes and periodontal diseases since 2000 and (b) effects of periodontal infection on glycemic control and diabetes complications since 1960.


RESULTS
Observational studies provided consistent evidence of greater prevalence, severity, extent, or progression of at least one manifestation of periodontal disease in 13/17 reports reviewed. Treatment and longitudinal observational studies provided evidence to support periodontal infection having an adverse effect on glycemic control, although not all investigations reported an improvement in glycemic control after periodontal treatment. Additionally, evidence from three observational studies supported periodontal disease increasing the risk for diabetes complications and no published reports refuted the findings.


CONCLUSIONS
The evidence reviewed supports diabetes having an adverse effect on periodontal health and periodontal infection having an adverse effect on glycemic control and incidence of diabetes complications. Further rigorous study is necessary to establish unequivocally that treating periodontal infections can contribute to glycemic control management and to the reduction of the burden of diabetes complications.
Taylor
G W
GW
School of Dentistry, University of Michigan, Ann Arbor, MI 48109, USA. gwt@umich.edu
Borgnakke
W S
WS
D001786:Blood Glucose / Q000032:analysis; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000097:blood / Q000378:metabolism*; D005947:Glucose / Q000378:metabolism; D017127:Glycation End Products, Advanced / Q000097:blood; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism; D018384:Oxidative Stress; D010510:Periodontal Diseases / Q000097:blood / Q000150:complications*
D001786:Blood Glucose; D017127:Glycation End Products, Advanced; D018836:Inflammation Mediators; D005947:Glucose