Diabetes mellitus and periodontitis-a conundrum resolved

Periodontitis is an inflammatory and infectious disease affecting the supporting structures of the tooth resulting in alveolar bone loss and tooth loss. Systemic diseases like diabetes have an intimate relation with periodontitis as they share common mechanisms in pathogenesis. Advanced Glycation Endproducts (AGEs) seen in diabetes patients binds with collagen and decreases the turnover. In the presence of preexisting periodontal inflammation, this collagen breaks down leading to periodontitis. On the other hand, inflammatory mediators in periodontitis can lead to tissue resistance to insulin, eventually increasing the blood glucose level, increasing the susceptibility to diabetes. Understanding the exact etiology of both diabetes and periodontitis helps clinician to educate and motivate their patients in managing their glycemic levels as well as to take proper precautions in treating and managing the periodontitis.