From nature.com
On World Diabetes Day, 12 November 2024, the European Federation of Periodontology (EFP) called attention to the growing body of scientific evidence that underscores the critical connection between gum disease (periodontitis) and diabetes.
As diabetes continues to impact millions of lives globally, understanding its effects on oral health (as well as the effects of gum disease on diabetes) is essential for improving overall health. This year's theme, Diabetes and wellbeing, emphasised the need for accessible care and support for all individuals living with diabetes - and that includes prioritising gum health.
Anton Sculean, chair of EuroPerio11, the premier congress in periodontology, hosted by the EFP, said: ‘Recent research has shown that diabetes is not only a major risk factor for periodontitis but that the relationship between the two conditions is bidirectional, meaning they both influence and exacerbate one another. Moreover, moderate/severe periodontitis is associated with an increased risk of all-cause and CVD-related mortality in adults with diabetes.'
People with diabetes are significantly more susceptible to developing severe gum disease, with studies showing that they are at a threefold higher risk. The connection between these conditions is particularly evident in patients with poorly controlled blood sugar levels. The higher the level of hyperglycaemia, the more severe the gum disease tends to be. This is due to the impact of high blood sugar on the immune system, which weakens the body's ability to combat infections, including those in the gums. Additionally, diabetes disrupts the body's inflammatory response, resulting in an exaggerated immune reaction in the gums that leads to further tissue damage.
Conversely, periodontitis can complicate diabetes management. The inflammation caused by gum disease isn't confined to the gums; it can spread throughout the body, increasing systemic inflammation and, in turn, impairing insulin sensitivity. This makes it harder for people with periodontitis to control their blood sugar levels, contributing to a vicious cycle that complicates both conditions. Furthermore, it has been demonstrated that severe periodontitis may be a risk indicator to develop diabetes in patients initially normoglycemic.
Emerging evidence shows that treating periodontitis can lead to improved glycaemic control in people with diabetes, highlighting the importance of integrated care. This finding reinforces the need for dental professionals to work closely with other healthcare providers, ensuring that patients receive comprehensive care that addresses both their oral health and diabetes management.
The EFP has been a leader in raising awareness about the strong link between gum disease and diabetes. This topic will take centre stage at the upcoming EuroPerio11 congress in Vienna (14-17 May 2025). A dedicated session will explore clinical considerations for managing patients with diabetes and periodontal disease, including screening for diabetes in dental settings.
This World Diabetes Day, the EFP called on healthcare professionals, policymakers, and the public to ensure that gum health is part of diabetes care and to improve the well-being of people living with diabetes by supporting comprehensive and holistic healthcare systems that address the complex connections between oral and general health.
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