The relationship among periodontitis, diabetes mellitus and atherosclerotic cardiovascular disease is complex and can be thought of as a Bermuda triangle. A relationship has been demonstrated between periodontitis, a worsening in the condition of the vascular system and an increased total level of inflammatory markers. Patients with severe periodontitis also show raised levels of glycosylated haemoglobin. This means that severe periodontitis can be an early indication of diabetes mellitus. Periodontal treatment generally promotes improved blood sugar regulation in diabetes patients, an improved condition of the vascular system and a decrease in the total levels of inflammation. Factors such as genetics, lifestyle and the presence of other chronic co-morbidities contribute to the complexity of this relationship. For the treatment of severe periodontitis, interdisciplinary cooperation among dentists, general practitioners and internists is therefore recommended.
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