As the fifth deadliest disease in the United States, diabetes is one of our nation’s heaviest health burdens. The American Diabetes Association estimates that nearly 21 million children and adults in America are living with diabetes, either diagnosed (15 million) or undiagnosed (6 million). An additional 41 million Americans are believed to be pre-diabetic, according to the American Diabetes Association.

Diabetes creates a heavy economic burden for Americans as well. Total costs associated with diabetes in the United States are in excess of $132 billion annually, including $92 billion in direct medical costs and $40 billion in indirect costs resulting from disability, work loss and premature mortality. Individual costs are directly related to the extent and complications of the condition.

The relationship between diabetes and oral health, specifically periodontal disease, is well accepted in the medical and dental communities. Observational studies have consistently reported evidence of a greater prevalence, incidence, severity, extent or progression of periodontal disease in diabetics. These studies also show that diabetic patients experience periodontal destruction at an earlier age than nondiabetic individuals. Diabetes represents an increased risk for periodontal disease by a factor of 2.1 to 3.0.

Beyond the established role of diabetes worsening periodontal disease, many researchers believe that severe periodontal disease increases the severity of diabetes and complicates metabolic control. A number of studies have shown that treatment of periodontal disease improves glycemic control. The association between the elimination of periodontal infection and improved glycemic control in diabetic patients lends support to the theory that diabetes increases periodontal disease incidence and severity, and severe periodontal disease increases the severity of diabetes and complicates metabolic control.