Oral manifestations. Periodontal disease is the most frequent
oral complication of diabetes, as reported by Löe
(6) in 1993, who referred to it as “the sixth complication
of diabetes mellitus” (the other five complications are:
retinopathy, nephropathy, microvascular disease and peripheral
vascular disease) (4).
A patient with poorly controlled diabetes has a major risk
of developing periodontal disease (5, 7), which will start
as gingivitis and gradually, if the glycemic control is deficient,
this may progress to an advanced periodontitis.
Diabetic children and adults without proper control of
their diabetes show a tendency to present higher gingival
indexes. Besides, several studies have demonstrated that
patients with poorly controlled type 1 DM have more advanced
and severe periodontal disease than patients with
an adequate glycemic control; this could be due to the
association found between poorer glycemic control and
elevated gingival crevicular fluid interleukin-1β (7).