HJAR May/Jun 2020

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2020 53 Niki Carter, DMD Dental Director Delta Dental of Arkansas exist. These bacteria enter the bloodstream orally and travel to the rest of the body 4 . This particular oral status of periodontal disease is one that has certain implications, espe- cially if an individual has diabetes. Diabetics have impaired wound healing, whichmeans they have a harder time fighting infections throughout the body 5 . This makes diabetic patients more susceptible for periodontal issues. These two chronic diseases impact public health significantly in quality of life, lifespan, and healthcare costs. In the U.S., the pub- lic health impact of diabetes is enormous. Complicating this is the fact that many who suffer from diabetes are totally unaware they have the condition. It is estimated that more than half a million children age 14 and younger have type 1 diabetes. The preva- lence of type 2 diabetes and periodontal diseases has increased worldwide. Accord- ing to the International Diabetes Federation, 415 million adults ages 20 to 79 have diabe- tes worldwide, which includes 193 million individuals who remain undiagnosed. This number does not include those people who are pre-diabetic, which places them at risk of developing the disease. Most disturbing is that the incidence of diabetes is estimated to increase to 640 million by 2040 6 . Most U.S. healthcare spending already goes toward chronic illness costs 7 . Chronic inflammation is the known mechanism that links periodontal disease and diabetes, and both diseases contribute to each other’s severity and worsen each other’s prognosis 8 . A bi-directional asso- ciation between diabetes and periodontal disease has been shown, in which diabetes increases the risk for periodontitis, and this periodontal inflammatory process nega- tively affects the glycemic control of dia- betics 9 . Acause-and-effect relationship has not been clearly defined between these two diseases, but inflammation is the common denominator both diseases share. Multiple factors have been suggested to explain the link between these two diseases. The mecha- nisms by which these diseases progress are controlled and regulated by metabolic and im-mune interactions. The long-term chronic effects of these as- sociated pathologies consist of increased tissue damage, increased disease severity, On a positive note, periodontal treatment decreases diabetic symptoms, which identifies and confirms the association and importance of oral health in overall health.