The link between diabetes and periodontitis

The complex interplay between diabetes and periodontitis deserves particular attention: it reveals a deep connection between these two chronic inflammatory diseases. This two-way association, highlighted by extensive work from the European Federation of Periodontology (EFP, 2019), shows how significantly each influences the other.

A close connection

People with diabetes are three times more likely to develop periodontitis, and people with periodontitis are more likely to develop diabetes. This connection underlines how important regular periodontal follow-up is for patients with diabetes.

How diabetes affects periodontitis

Diabetes, characterised by chronic high blood sugar, creates an inflammatory environment favourable to the early and severe development of periodontitis. Patients with diabetes are therefore more likely to experience aggressive forms of the disease, which calls for specific management.

How periodontitis hinders diabetes control

Conversely, periodontitis can make diabetes harder to control. Bacteria from diseased gums can enter the bloodstream, intensifying complications of diabetes such as atherosclerosis and stroke.

Care adapted to patients with diabetes

Managing periodontitis in patients with diabetes requires a specific approach. The treatment protocol frequently includes antibiotics, more root planing sessions and more closely spaced periodontal maintenance appointments. The 2018 classification of periodontal diseases distinguishes cases according to how well the diabetes is controlled, which allows care to be tailored.

A public health issue

With diabetes affecting 415 million people worldwide, and periodontitis affecting up to one adult in two in Western Europe, the public health stakes are considerable. French social security has offered partial reimbursement for periodontal treatment since April 2019. The Sophia programme, launched in 2008, offers specific support and already counted 800,000 members in 2019.

Going further

• The Sophia diabetes programme.
• The recommendations of the European Federation of Periodontology (EFP).
• The information booklet of the French Federation of People with Diabetes.

Managing diabetes and periodontitis together matters for overall health. We strongly encourage all patients with diabetes to be aware of this connection and to take a proactive approach to oral care.