Bilateral Interrelationship of Diabetes and Periodontium

Periodontitis is a chronic inflammatory disease characterised by destruction of the supporting structures of the teeth which is a common cause of tooth mortality in all individuals throughout the world. Diabetes is a group of metabolic dysregulation, primarily of carbohydrate metabolism, characterized by hyperglycemia that results from defects in insulin secretion, impaired insulin action, or both. Systematic reviews and meta-analysis have shown that the prevalence of periodontitis is increased in diabetic patients. Based on the evidence, degree of hyperglycemia and severity of periodontitis are inter- related. Diabetic patients with severe periodontitis have six times more poor glycemic control than patients with healthy periodontium. However, improved glycemic control has been postulated to reduce the severity of periodontal disease. In this mini-review, we have presented the previously reviewed studies from the literature and focused on a two-way relationship of diabetes and periodontitis, various pathways involved in it such as RANK/RANKL/OPG axis, AGE-RAGE pathway, Oxidative stress mechanism, and obesity that influence the possibility of periodontitis-Diabetes Mellitus (DM).