Periodontitis management in diabetes care.

Periodontitis is the chronic inflammation of the oral cavity involving the gum, teeth and the supporting bone. Since it appears to have a similar pathophysiology as other microvascular complications of diabetes it can be considered to be the fourth chronic microvascular complication of diabetes mellitus. There is a three-fold increase in risk of periodontal disease among patients with diabetes mellitus. Periodontitis in diabetes is associated with increased myocardial infarctions, strokes and renal related complications, poor glycaemic control and an increase in the risk of dying of cardiorenal causes. However, treatment of periodontal disease has been demonstrated to improve glucose control and reduce inflammatory markers. Improvements in periodontal health among patients with diabetes mellitus can be achieved with better oral health education, oral examination in diabetic clinics during regular visits and annual dental examinations by qualified dentists. Dental treatments for periodontal infections include mechanical disruption of the pathogenic biofilm using scaling and planing, use of systemic antibiotics to treat refractory pathogens and specialized dental surgery in advanced disease.