Diabetes Mellitus (DM) is a chronic metabolic disease characterized by hyperglycemia due to impaired insulin secretion, insulin action, or both. In addition to systemic complications such as neuropathy, nephropathy, and retinopathy, DM is also closely associated with oral health conditions, particularly periodontitis.
Periodontitis is a chronic inflammation of the tooth-supporting tissues caused by bacterial infection, leading to the destruction of the alveolar bone and periodontal ligament. Research has shown a bidirectional relationship between DM and periodontitis, where each condition worsens the other.
Mechanisms Linking DM and Periodontis
Patients with DM, especially those with uncontrolled diabetes, experience impaired immune response and wound healing. This condition leads to increased:
- Inflammatory response to bacterial plaque
- Production of pro-inflammatory cytokines such as IL-1β and TNF-α
- Accumulation of Advanced Glycation End Products (AGEs) that damage periodontal tissues
As stated in an article in Jurnal MKGK FKG UGM by Bondan Purbowati and Aris Aji Kurniawan, chronic hyperglycemia in diabetic patients disrupts the immune system, exacerbates the inflammatory response, and increases susceptibility to periodontal infection.
Severity of Periodontitis in Diabetic Patients
Patients with DM are more likely to experience:
- Bleeding gingiva
- Deeper periodontal pockets
- Gingival recession
- Tooth mobility
- Faster tooth loss
The prevalence and severity of periodontitis are higher in diabetic patients compared to non-diabetics. This confirms that DM is a significant risk factor for more severe and progressive chronic periodontitis.
Clinical Implications
- Periodontitis in diabetic patients can impair glycemic control, creating a vicious cycle that aggravates both conditions.
- Routine periodontal care is essential to improve metabolic control in diabetic patients.
- Dentists and physicians must collaborate in the comprehensive monitoring and management of diabetic patients..
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There is a two-way relationship between Diabetes Mellitus and periodontitis, where each condition can exacerbate the other. Therefore, periodontal management must be an integral part of the routine care of diabetic patients, for both oral health and overall systemic health.
References
MKGK, Bondan Purbowati, Aris Aji Kurniawan, Chronic periodontitis in patients with diabetes mellitus, https://journal.ugm.ac.id/mkgk/article/view/37775
Author: Rizky B. Hendrawan | Editor: drg. Aulia Ayub, Sp.Ort
Photo: Freepik
