Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. Of the 20.8 million children and adults in the United States who have diabetes, nearly one-third are unaware that they have the disease.1 Recent research has suggested that periodontitis is often associated with diabetes and might be considered one of the chronic complications of the disease. A recent study consisting of over 200 subjects examined the relationship between diabetes and periodontitis. The results of the study indicate that subjects with diabetes had a greater level of periodontitis than subjects who did not have the disease.2
Important factors to consider in assessing the periodontal status of and formulating treatment plans for patients with diabetes include their degree of metabolic control, the duration of their disease, the presence of other long-term complications of diabetes, the presence of concurrent risk factors and their general level of well-being.
Emphasis should be placed on the reduction of the bacteria and elimination of the biofilm, both above and below the gumline. This can be accomplished with traditional scaling and root planing in addition to excellent home care. Treatment should focus on the prevention of periodontal disease and oral inflammation, which is essential in controlling the oral complications associated with diabetes. And, because we know that bacterial challenge is a risk factor for gingivitis among even healthy, well-controlled diabetic patients, patients should be encouraged to floss regularly and brush twice daily with a toothpaste that offers anti-bacterial protection.