Periodontal Disease and Diabetes Mellitus: A Two‐Way Relationship
Abstract
Severe periodontal disease often coexists with severe diabetes mellitus. Diabetes is a risk factor for severe periodontal disease. A model is presented whereby severe periodontal disease increases the severity of diabetes mellitus and complicates metabolic control. We propose that an infection‐mediated upregulation cycle of cytokine synthesis and secretion by chronic stimulus from lipopolysaccharide (LPS) and products of periodontopathic organisms may amplify the magnitude of the advanced glycation end product (AGE)‐mediated cytokine response operative in diabetes mellitus. In this model, the combination of these 2 pathways, infection and AGE‐mediated cytokine upregulation, helps explain the increase in tissue destruction seen in diabetic periodontitis, and how periodontal infection may complicate the severity of diabetes and the degree of metabolic control, resulting in a 2‐way relationship between diabetes mellitus and periodontal disease/infection. This proposed dual pathway of tissue destruction suggests that control of chronic periodontal infection is essential for achieving long‐term control of diabetes mellitus. Evidence is presented to support the hypothesis that elimination of periodontal infection by using systemic antibiotics improves metabolic control of diabetes, defined by reduction in glycated hemoglobin or reduction in insulin requirements . Ann Periodontol 1998;3:51–61.
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Oral bacteria are associated with many systemic diseases including arthritis, cardiovascular disease, and diabetes.
“Notably, oral bacteria are also associated with many systemic diseases including arthritis28, cardiovascular disease3 and diabetes4, in addition to diseases of the oral cavity1,2.”
From Sequencing ancient calcified dental plaque shows changes in oral microbiota with dietary shifts of the Neolithic and Industrial revolutions (2013) · cites this paper as [4]
Commensal microbiota comprise the majority of cells in the body and play a key role in human health.
“Commensal microbiota comprise the majority of cells in the body and play a key role in human health1-5,10.”
From Sequencing ancient calcified dental plaque shows changes in oral microbiota with dietary shifts of the Neolithic and Industrial revolutions (2013) · cites this paper as [4]
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- Authors
- Grossi, S. G., & Genco, R. J.
- Affiliations
- University at Buffalo, State University of New York (US)
- Corresponding author
- Grossi, Sara G.
- ORCID
- Genco, Robert J.
- Venue
- Annals of Periodontology
- Publisher
- Wiley
- Published
- 1998-07
- Volume
- 3
- Issue
- 1
- Pages
- 51-61
- ISSN
- 1553-0841 (ISSN-L)
- 2162-5131
- OpenAlex
- W2175404989
- Cited by
- 842
- References
- 59
- Citations by year
- 2026: 11 · 2025: 17 · 2024: 25 · 2023: 21 · 2022: 40 · 2021: 40 · 2020: 39 · 2019: 39 · 2018: 32 · 2017: 24 · 2016: 40 · 2015: 36 · 2014: 52 · 2013: 61 · 2012: 35
- FWCI
- 19.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Periodontology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p50de004898-20)
- U.S. Public Health Service (PN92189)
- National Institute of Dental and Craniofacial Research (DE-04898)
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Medicine › Urology › Periodontal Regeneration and Treatments
- Health Sciences › Dentistry › General Dentistry › Dental Research and COVID-19
- Keywords
- periodontal disease, diabetes mellitus, diabetic periodontitis, periodontal infection, advanced glycation end products, cytokine response, lipopolysaccharide, periodontal pathogens, glycemic control, HbA1c, insulin requirement, systemic antibiotics, tissue destruction
- MeSH terms
- Anti-Bacterial Agents, Chronic Disease, Diabetes Mellitus, Type 2, Humans, Hyperglycemia, Periodontal Diseases, Up-Regulation, Cytokines, Gram-Negative Bacterial Infections, Glycation End Products, Advanced
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