Link between Periodontal Disease and Diabetes

The human body is a single unit composed of a seemingly infinite number of biological processes that are so intertwined that a problem in any one system can have a profound effect on multiple other areas of the body.


As the entry point to the body, the mouth is no exception.


The two-way relationship between periodontitis and diabetes is the strongest among all systemic diseases.  Diabetes has been shown to increase the prevalence, severity (Stage), and rate of progression (Grade) of periodontitis.  And, periodontitis has been shown to influence blood sugar control in diabetic patients.

This link between gum disease and diabetes is not direct, but instead diabetes affects the pathogenesis of periodontal disease by altering the immune response and inflammation, increasing the risk of infection via high blood sugar, and by causing oral microbiome changes.


In the other direction, periodontal disease increases insulin resistance through persistent and chronic systemic inflammation.


Several studies have investigated the effect of a deep periodontal cleaning on diabetes.  They found that with the elimination of the bacterial infection, patients saw improved insulin sensitivity, improved glycemic control, and reduced HbA1c levels by 0.48% for at least 3 months following treatment.


This drastic reduction in glycosylated hemoglobin (Hba1c), which is a chronic measure of blood glucose, is similar to if you had added a second drug to a person’s usual diabetes medication regiment.


The link between gum disease and diabetes is so strong, that it has been suggested that periodontal disease be listed among the “classic complications” of diabetes, alongside stroke, kidney failure, and retinopathy.


Although the link is strong, 33% of people living with diabetes are unaware that it can affect their gum health.

Periodontal disease is a chronic bacterial infection resulting in inflammation.  Periodontal disease causes an immune response throughout the entire body, affecting many of the body’s systems.


Periodontal disease severity has been linked to many auto-immune, genetic, and acquired immune disorders.  These include:

  • Type I Diabetes
  • Rheumatoid Arthritis
  • Lupus
  • Crohn’s and Ulcerative Colitis
  • Irritable Bowel Syndrome
  • HIV
  • Vitamin D deficiency
  • Down’s Syndrome

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