Modifiable Risk Factors for Periodontitis and Diabetes

This review describes the evidence published from January 2013 through March 2016 for modifiable risk factors for chronic periodontitis and diabetes mellitus. Risk factors are factors that increase the chance of developing the disease. Modifiable risk factors for both these chronic, inflammation-related diseases include the following: hyperglycemia; microbial overgrowth, infection, and inflammation (virus, poor oral hygiene, gut microbiome); overweight and obesity; metabolic syndrome; hyperlipidemia; medication; unhealthy diet (added sugar; alcohol and other non-sugary carbohydrates, fat, and meat; nutrition, minerals (including zinc), and vitamins); current tobacco smoking (including environmental tobacco smoke); sedentary lifestyle; sleep disturbances; stress, depression, anxiety, poor coping skills, and allostatic load; low health literacy; and the environment and pollution.Given the similarity between the inflammatory mechanisms underlying chronic periodontitis and diabetes mellitus, one can wonder: Could these diseases both be somewhat different manifestations of inflammatory response-based overload? Could both periodontitis and diabetes even be regarded as autoimmune diseases that are manifested due to poor biologic and psychologic coping skills in response to the micro- and macro-level stressors that cause inflammation?Any successful intervention must include more measures than clinical medical/dental care can provide and hence might benefit from active participation of all parties, first and foremost the patient, in a patient-centered, interprofessional health care (not merely disease care) collaboration for the benefit of the mutual patient.But first, it is necessary to be aware of the risk factors that can be modified to pose less risk, a goal toward which this review hopefully will be helpful.