Both periodontal disease and diabetes are multifactorial diseases that have many comorbidities and have been shown to increase host inflammatory burden. Diabetes is also associated with other dental conditions and diseases, including xerostomia (dry mouth), dental caries, and oral candidiasis.90 Good oral health is integral to optimal overall health and quality of life,91 but the interactions between systemic and oral health may not be the primary focus of physicians and other healthcare providers.92 Therefore, dental healthcare providers should be aware of the burden and risks of diabetes and its oral manifestations, including rapid periodontal disease progression and make appropriate referrals when indicated. Likewise, patients who have been diagnosed with diabetes mellitus should be carefully questioned about their glycemic control and overall oral health status. Periodontal disease and the inflammatory burden it creates should be discussed with patients and the use of advanced therapies and/or more stringent maintenance protocols to control the increased inflammatory load in patients with both diabetes and periodontitis should be considered.
Comanagement of patients with diabetes and periodontal disease will promote better dental and medical care for patients. Appropriate diagnoses and communication between practitioners will allow for patient screening for additional comorbidities, which will lead to earlier detection and treatment. This information can also characterize the patients’ overall glycemic control which will allow for personalization of treatment plan and maintenance protocols.
In the dental office, patients’ glycemic control should be monitored to ensure that a medical emergency from hypo- or hyperglycemia does not occur. Counseling patients about the effects that their diabetes may have on their oral condition is also an important step in encouraging patients to optimally control their diet and/or medications to maintain a healthy level of glycemic control, which can improve their overall and oral health.