Effect of periodontal disease on children with diabetes and their quality of life


  • Hanan R. Aljohani Department of Pediatric Dentistry, King Abdullah Medical Complex, Jeddah, Saudi Arabia
  • Abdulsalam M. Almazyad Department of Dentistry, Samira General Hospital, Hail, Saudi Arabia
  • Atheer M. Asiri Department of Dentistry, Awaldent Medical complex, Abha, Saudi Arabia
  • Rana H. Aref Department of Dentistry, Al Harasani Dental Clinics, Jeddah, Saudi Arabia
  • Naief A. A. L. Dweesh Department of Dentistry, Bisha General Medical Polyclinic, Bisha, Saudi Arabia
  • Abeer H. Asiri Department of Dentistry, Dentally Dental Clinic, Abha, Saudi Arabia
  • Nouf N. Aljami Department of Dentistry, Armed Forces Hospital, Al-Kharj, Saudi Arabia
  • Mamdouh A. Alzahrani College of Dentistry, Baha University, Al Baha, Saudi Arabia
  • Mohammad Y. Assiri Department of Dentistry, Prince Mohammed bin Abdulaziz Hospital, Riyadh, Saudi Arabia
  • Abdalmohsen A. Kemawi Department of Dentistry, Dr. Khalid Bakhsh General Medical Group, Mecca, Saudi Arabia
  • Wiaam I. Moussa Department of Dentistry, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia




Juvenile-onset diabetes mellitus, Periodontitis, Periodontal disease, Metabolic syndrome, Quality of life


Diabetes mellitus (DM) is a life-altering and comparatively prevalent chronic condition affecting children. The root cause of the condition is linked to the pancreatic islets of Langerhans, which produce the hormone insulin and are destroyed by an autoimmune inflammation. The illness then shows up clinically as a result. In the context of the combination of hereditary and external variables, the condition emerges in people with polygenic genetic susceptibility. Concerning a potential connection involving DM and periodontitis, many investigations have been released. Conflicting results, though, have been recorded. Certain authors believe that individuals with DM have significantly higher levels of gingival inflammation and marginal periodontitis than non-DM controls, despite the fact that this association has not been discovered in another research. Dental plaque microbes are the primary cause of periodontal pathologies, in which the tissues around the teeth become infected. Periodontitis manifests in DM patients earlier than it does in the general demographic of healthy individuals. Periodontal deterioration typically shows up in children with DM throughout puberty, while it can happen sooner. Also, in juvenile subjects with type 1 DM, the development of periodontal infection has been linked to poorly managed DM. Elevated access to glucose in both the fluid around the gingival crevice and saliva promotes the growth of caries and periodontal pathology causing microbes and worsens oral inflammation. Owing to inflammation, periodontal disease affects the cellular and humoral immune systems. The generation of insulin and metabolic control are impacted by these modifications in immune responses. Thus, periodontal disease can hinder glycemic control, and impaired metabolic control can further encourage periodontitis; a loop may be generated that worsens both problems. Hence, it is vital to prevent and manage oral inflammatory conditions in order to effectively prevent and control DM complications. 


Gardner DG, Shoback DM. Greenspan’s basic and clinical endocrinology. McGraw-Hill Education. 2017.

Oikarinen S, Tauriainen S, Hober D, Lucas B, Vazeou A, Sioofy-Khojine A, et al. Virus antibody survey in different European populations indicates risk association between coxsackievirus B1 and type 1 diabetes. Diabetes. 2014;63(2):655-62.

Hober D, Sane F. Enteroviral pathogenesis of type 1 diabetes. Discovery Med. 2010;10(51):151-60.

Virtanen SM, Knip M. Nutritional risk predictors of β cell autoimmunity and type 1 diabetes at a young age. Am J Clin Nutr. 2003;78(6):1053-67.

D’Angeli MA, Merzon E, Valbuena LF, Tirschwell D, Paris CA, Mueller BA. Environmental factors associated with childhood-onset type 1 diabetes mellitus: an exploration of the hygiene and overload hypotheses. Arch Pediatrics Adolescent Med. 2010;164(8):732-8.

Cinek O. Epidemiology of childhood type 1 diabetes mellitus: lessons from central and Eastern European data. Hormone Res Paediatrics. 2011;76(1):52-6.

Cohen DW, Friedman LA, Shapiro J, Kyle GC, Franklin S. Diabetes mellitus and periodontal disease: Two‐year longitudinal observations part I. J Periodontol. 1970;41(12):709-12.

Bernick SM, Cohen DW, Baker L, Laster L. Dental disease in children with diabetes mellitus. J Periodontol. 1975;46(4):241-5.

Gislen G, Nilsson KO, Matsson L. Gingival inflammation in diabetic children related to degree of metabolic control. Acta Odontologica Scandinavica. 1980;38(4):241-6.

Ringelberg M, Dixon D, Francis A, Plummer R. Comparison of gingival health and gingival crevicular fluid flow in children with and without diabetes. J Dent Res. 1977;56(2):108-11.

Cianciola L, Park B, Bruck E, Mosovich L, Genco R. Prevalence of periodontal disease in insulin-dependent diabetes mellitus (juvenile diabetes). J Am Dent Assoc. 1982;104(5):653-60.

Hove KA, Stallard RE. Diabetes and the periodontal patient. J Periodontol. 1970;41(12):713-8.

Bay I, Ainamo J. Caries experience among children in Copenhagen. Comm Dentistry Oral Epidemiol. 1974;2(2):75-9.

Barnett ML, Press KP, Friedman D, Sonnenberg EM. The prevalence of periodontitis and dental caries in a Down's syndrome population. J Periodontol. 1986;57(5):288-93.

Yusof W. Periodontitis in children, adolescent and young adults. The changing concepts: 2. Aetiology and treatment. Singapore Dent J. 1988;13(1):4-9.

Orbak R, Simsek S, Orbak Z, Kavrut F, Colak M. The influence of type-1 diabetes mellitus on dentition and oral health in children and adolescents. Yonsei Med J. 2008;49(3):357-65.

Xavier ACV, Silva IN, Costa FdO, Corrêa DS. Periodontal status in children and adolescents with type 1 diabetes mellitus. Arq Bras Endocrinol Metab. 2009;53(3):348-54.

Siudikienė J, Mačiulskienė V, Dobrovolskienė R, Nedzelskienė I. Oral hygiene in children with type I diabetes mellitus. Stomatologija. 2005;7(1):24-7.

Lalla E, Cheng B, Lal S, Tucker S, Greenberg E, Goland R, et al. Periodontal changes in children and adolescents with diabetes: a case-control study. Diabetes Care. 2006;29(2):295-9.

Preshaw P, Alba A, Herrera D, Jepsen S, Konstantinidis A, Makrilakis K, et al. Periodontitis and diabetes: a two-way relationship. Diabetologia. 2012;55(1):21-31.

Thorstensson H. Periodontal disease in adult insulin-dependent diabetics. Swedish Dent J Suppl. 1995;107:1-68.

Dusková J, Broukal Z. Compensation criteria of basal disease in the prevention and treatment of periodontal disease in patients with diabetes mellitus. Prakticke Zubni Lekarstvi. 1991;39(2):51-4.

Iughetti L, Marino R, Bertolani MF, Bernasconi S. Oral health in children and adolescents with IDDM-a review. J Pediatric Endocrinol Metab. 1999;12(5):603-10.

Lalla E, Cheng B, Lal S, Kaplan S, Softness B, Greenberg E, Goland RS, et al. Diabetes mellitus promotes periodontal destruction in children. J Clin Periodontol. 2007;34(4):294-8.

Salvi GE, Carollo‐Bittel B, Lang NP. Effects of diabetes mellitus on periodontal and peri‐implant conditions: update on associations and risks. J Clin Periodontol. 2008;35:398-409.

Tervonen T, Lamminsalo S, Hiltunen L, Raunio T, Knuuttila M. Resolution of periodontal inflammation does not guarantee improved glycemic control in type 1 diabetic subjects. J Clin Periodontol. 2009;36(1):51-57.

Llambés F, Silvestre F-J, Hernández-Mijares A, Guiha R, Caffesse R. The effect of periodontal treatment on metabolic control of type 1 diabetes mellitus. Clin Oral Investig. 2008;12(4):337-43.

Calabrese N, D’aiuto F, Calabrese A, Patel K, Calabrese G, Massi-Benedetti M. Effects of periodontal therapy on glucose management in people with diabetes mellitus. Diabetes Metabol. 2011;37(5):456-9.

Nishimura F, Takahashi K, Kurihara M, Takashiba S, Murayama Y. Periodontal disease as a complication of diabetes mellitus. Ann Periodontol. 1998;3(1):20-9.

Ryan ME, Ramamurthy NS, Sorsa T, Golub LM. MMP‐mediated events in diabetes. Ann New York Acad Sci. 1999;878(1):311-34.

Ryan ME, Carnu O, Kamer A. The influence of diabetes on the periodontal tissues. J Am Dent Assoc. 2003;134:34S-40S.

Ryan ME, Usman A, Ramamurthy N, Golub LM, Greenwald RA. Excessive matrix metalloproteinase activity in diabetes: inhibition by tetracycline analogues with zinc reactivity. Curr Med Chem. 2001;8(3):305-16.

Grover HS, Luthra S. Molecular mechanisms involved in the bidirectional relationship between diabetes mellitus and periodontal disease. J Indian Soc Periodontol. 2013;17(3):292.

Slade G, Offenbacher S, Beck J, Heiss G, Pankow J. Acute-phase inflammatory response to periodontal disease in the US population. J Dent Res. 2000;79(1):49-57.

Mølvig J, Baek L, Christensen P, Manogue KR, Vlassara H, Platz P, et al. Endotoxin‐stimulated human monocyte secretion of interleukin 1, tumour necrosis factor alpha, and prostaglandin E2 shows stable interindividual differences. Scand J Immunol. 1988;27(6):705-16.

Taylor GW. The effects of periodontal treatment on diabetes. J Am Dent Assoc. 2003;134:41S-8S.

Kornman KS. Mapping the pathogenesis of periodontitis: a new look. J Periodontol. 2008;79:1560-8.

Alonso N, Martínez-Arconada MJ, Granada ML, et al. Regulatory T cells in type 1 diabetic patients with autoimmune chronic atrophic gastritis. Endocrine. 2009;35(3):420-8.

Matthews DC. The relationship between diabetes and periodontal disease. J Canad Dent Assoc. 2002;68(3):161-4.




How to Cite

Aljohani, H. R., Almazyad, A. M., Asiri, A. M., Aref, R. H., Dweesh, N. A. A. L., Asiri, A. H., Aljami, N. N., Alzahrani, M. A., Assiri, M. Y., Kemawi, A. A., & Moussa, W. I. (2022). Effect of periodontal disease on children with diabetes and their quality of life. International Journal Of Community Medicine And Public Health, 10(1), 438–442. https://doi.org/10.18203/2394-6040.ijcmph20223570



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