Chapter 23. Treatment of Periodontal Disease

  1. R. Williams3,
  2. W. Herman4,
  3. A.-L. Kinmonth6 and
  4. N. J. Wareham5
  1. George W. Taylor1 and
  2. Sara G. Grossi2

Published Online: 9 APR 2003

DOI: 10.1002/0470846585.ch23

The Evidence Base for Diabetes Care

The Evidence Base for Diabetes Care

How to Cite

Taylor, G. W. and Grossi, S. G. (2002) Treatment of Periodontal Disease, in The Evidence Base for Diabetes Care (eds R. Williams, W. Herman, A.-L. Kinmonth and N. J. Wareham), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470846585.ch23

Editor Information

  1. 3

    Nuffield Institute for Health, University of Leeds, 71-75 Clarendon Road, Leeds LS2 9PL, UK

  2. 4

    Department of Internal Medicine and Epidemiology, 1500 East Medical Center Drive, 3920 Taubman Center, Box 0345, Ann Arbor, MI 48109, USA

  3. 5

    Department of Public Health and Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

  4. 6

    General Practice and Primary Care Research Unit, Dept. of Public Health & Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

Author Information

  1. 1

    Department of Cardiology, Restorative Sciences and Endodontics, The University of Michigan School of Dentistry, 1011 N University, Ann Arbor, MI 48109-1078, USA

  2. 2

    Department of Oral Biology, State University of New York at Buffalo, 135 Foster Hall, Buffalo, NY 14214, USA

Publication History

  1. Published Online: 9 APR 2003
  2. Published Print: 27 AUG 2002

ISBN Information

Print ISBN: 9780471988762

Online ISBN: 9780470846582



  • bacterial infection;
  • gingivitis;
  • periodontitis;
  • glycemic control;
  • inflammation;
  • cellular mechanism;
  • molecular dynamics;
  • antibiotic therapy;
  • mechanical therapy


Periodontal disease is a chronic, potentially progressive bacterial infection that results in inflammation and destruction of tooth-supporting tissues. Clinicians have long assumed that diabetes and periodontal disease are biologically linked but support for a causal relationship has been established only recently. This chapter reviews all studies published in the English language since 1960 that compared periodontal health in subjects with and without diabetes. All studies of patients with type 1 diabetes reported greater prevalence, extent or severity on at least one measure of periodontal disease. There are fewer studies on type 2 diabetes but they all showed that these patients had significantly poorer periodontal health. Current evidence supports poor glycemic control as a contributor to poor periodontal health. The biological mechanisms are reviewed. There is also evidence for periodontal infection adversely affecting glycemic control in diabetes but further trials are required here. Treatment should aim to arrest the periodontal infection and control the inflammatory destructive process.