BIDIRECTIONAL RELATIONSHIP BETWEEN DIABETES MELLITUS AND PERIODONTAL DISEASE: A LITERATURE REVIEW

Abstract

Diabetes mellitus (DM) and periodontal disease (PD) are chronic conditions of great public health relevance, and the literature describes a bidirectional relationship between them. This study aimed to understand, through an integrative literature review, the pathophysiological mechanisms and clinical implications of this relationship. The search was carried out in the Virtual Health Library (BVS) portal, using the descriptors “diabetes mellitus” and “periodontitis”, considering literature reviews published between 2022 and 2025, in Portuguese, English and Spanish, with full text available. Of the 2,501 records identified, 14 articles were included and analyzed descriptively according to four thematic axes. The studies indicate that persistent hyperglycemia favors immunoinflammatory changes, oxidative stress, accumulation of advanced glycation end products and mitochondrial dysfunction, increasing the susceptibility to and severity of periodontitis. Conversely, periodontal inflammation raises the systemic inflammatory burden, with mediators such as TNF-α and IL-6, and may impair insulin signaling and glycemic control. Periodontal treatment may contribute to metabolic improvement in certain patients, although the results are not uniform. It is concluded that the bidirectional relationship is supported by the literature and that integrated follow-up between dentists and professionals responsible for metabolic care is essential in the management of diabetic patients.