Endocrine Abstracts

Physicians and dentists have long known that the health of an individual’s mouth can have significant effects on the health of the rest of the body. Researchers are finding more medical reasons to maintain good oral hygiene. Numerous recent scientific studies indicate association between oral health and a variety of general health conditions including diabetes and obesity. Studies have suggested a bidirectional relationship between periodontitis and diabetes and periodontitis and obesity. Diabetes and obesity promote the occurence, the progression and the severity of periodontitis. Conversely, periodontitis was shown to be a risk factors for poor glycemic control in patients with diabetes due to bacteria and their byproducts in the inflammed periodontal tissue constituting a chronic source of systemic chalenge to the host, increases the risk of diabetes-associated complications and possibly even of ist onset. Some studies suggest mechanisms by which oral bacteria may contibute to development of obesity by increasing apetite and changing of diet habits and redirecting energy metabolism by facilitating insulin resistance through increasing levels of TNF-α or reducing levels of adiponectin. Tooth loss due to periodontitis seriously decreases chewing abillity which is related to quality of life and general health, possibly reflecting the impact on chewing food choice and enjoyment of meals and diet and also indicated the importance of oral health to general well-beeing. It is still not sufficienty communicated within the medical community, because the periodontal disease is stil considered as the concern of only dentists. Physicians and dentists need to be aware of the relationship between periodontitis and diabetes and take adaquate steps to minimaze negative outcomes in patient with diabetes mellitus or obese patients.Periodontal therapy which decreases the intraoral bacterial bioburden and reduces periodontal inflammation can have a significant impact on systemic inflammatory status and improves glycemic control in many patients with diabetes and periodontitis. Recognition of the bilateral relationship between oral and systemic helath will chalenge physicians and dentists to work together closely in the future when managing patients with diabetes and periodontal disease. The entire dental team, working together with medical colleagues, must become increasingly involved in the management of patients with diabetes and perform periodontal screening as a matter of routine of all patients diagnosed with diabetes mellitus and periodontitis.