Diabetes: An important risk factor to severe progressive oral infections
This review focuses on the relationship between diabetes and periodontal infection and potential mechanisms involved in local and systemic disease progression. In addition, various oral complications of diabetes are discussed, along with recommendations for management, treatment, and proper referral.
The oral cavity provides a continuous source of infectious agents, and its condition often reflects progression of systemic pathologies. Historically, oral infections were thought to be localized to the oral cavity except in the case of some associated syndromes and untreated odontogenic abcesses. A change in paradigm has dispelled this notion, and a whole new concept of the status of the oral cavity and its impact on systemic health and disease has evolved.
Diabetes affects > 18 million individuals in the United States and > 171 million individuals worldwide and has reached epidemic status.1 The disease is characterized by an increased susceptibility to infection, poor wound healing, and increased morbidity and mortality associated with disease progression. Diabetes is also recognized as an important risk factor for more severe and progressive periodontitis, infection or lesions resulting in the destruction of tissues and supporting bone that form the attachment around the tooth.
Both diseases are thought to share a common pathogenesis that involves an enhanced inflammatory response that can be observed at the local and systemic level.