Gum disease develops with chronic bacterial inflammation of the surrounding and supporting tissues (periodontium). When the inflammation progresses, it leads to periodontal disease (periodontitis) characterized by alveolar bone loss. Diabetes mellitus (DM) is a common metabolic disorder. In different studies, although the main factor of periodontitis is the biofilm layer of bacterial plaque, it revealed that diabetes, especially the uncontrolled ones, increases the severity of periodontal disease and adversely affects the treatment. Similarly, many studies have reported that periodontal disease affects glycemic control in diabetes. In summary, the relationship between diabetes and periodontal disease is bidirectional. Therefore, the treatment of periodontal disease in people with diabetes plays an important role in reducing the complications related to diabetes with the provision of glycemic control.
All dental treatments can be performed in patients with diabetes. However, to prevent a possible hypoglycemia (low blood glucose level) in patients receiving insulin, treatments should be planned between 30 minutes and 8 hours after insulin injection. If there are systemic complications due to diabetes, the patient should be examined by the physician before any surgical intervention and diabetic control should be provided first. In diabetic patients with severe periodontal disease, systemic antibiotics may be prescribed in addition to periodontal treatment.