A relationship between periodontal diseases, diabetes mellitus and diabetic nephropathy

Abstract

Diabetes mellitus is a metabolic disease estimated to affect over 5% of adult population. Among the late complications associated to the diabetes mellitus, periodontal disease has been highlighted, and it can be more severe and refractory to treatment than in healthy subjects. Periodontal disease is a microbe-induced chronic inflammatory condition that leads to gingival inflammation, periodontal tissue destruction, and alveolar bone loss. Certain anaerobic gram-negative bacteria within the plaque biofilm are the major etiological agents of periodontal disease. The host response in periodontal disease is characterized by the production of inflammatory mediators, cytokines and matrix metalloproteinases. Both hyper- and hypoglycemia influence on periodontal tissue condition. Poorly controlled diabetes mellitus leads to alveolar bone loss, loss of attachement and periodontal tissue destruction. An periodontal disease affects on worsening of glycemic control. There exists two-way relationship between both diseases.