PERIODONTAL DISEASE AND DIABETES MELLITUS:

a narrative review of the bidirectional relationship and its clinical implications

Abstract

The periodontium constitutes the essential support for teeth and is composed of gingiva, periodontal ligament, alveolar bone, and cementum, structures that work together to maintain dental function. Periodontitis, a chronic inflammatory disease of infectious origin, has a high global prevalence and, like diabetes mellitus, especially type 2, represents a significant public health problem. Several studies demonstrate a bidirectional relationship between these conditions, in which inadequate glycemic control favors the progression of periodontitis, while chronic periodontal inflammation negatively affects diabetes management. This study aimed to conduct a narrative literature review on the association between periodontal disease and diabetes mellitus, highlighting the pathophysiological mechanisms and clinical implications for dental practice. The research was carried out between March and May 2025 in the PubMed, SciELO, and Google Scholar databases, using descriptors in Portuguese and English, considering articles published in the last ten years, as well as key reference books in the field. Selected studies indicate that common inflammatory processes, alterations in gingival microbiota, and increased advanced glycation end products (AGEs) contribute to periodontal tissue destruction and glycemic imbalance, reinforcing the need for an interdisciplinary approach. Early diagnosis, strict diabetes control, and periodontal treatment—including scaling, root planing, and optimization of oral hygiene—show potential to improve glycemic control and reduce associated complications. These findings highlight that integrating medical and dental care is essential to promote systemic health and enhance patients’ quality of life.