Relationship between diabetes, hypertension and periodontal diseases: a systematic review of major clinical findings

Introduction: In the scenario of periodontal diseases, chronic periodontitis is one of the most frequent periodontal diseases in the adult population with poor oral hygiene. The aggravating factors of the disease can be the occurrence of loss of bone structure, loss of attachment, and formation of a periodontal pocket, and even periodontitis can produce changes in systemic health, including stroke, renal failure, premature birth, diabetes, arterial hypertension, and coronary diseases. Objective: A concise systematic review was carried out to elucidate through clinical studies the real relationship between periodontal diseases, diabetes, and arterial hypertension. Methods: The rules of the Systematic Review-PRISMA Platform. The research was carried out from May 2022 to July 2022 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 127 articles were found. In total, 57 articles were fully evaluated and 18 were included and evaluated in this systematic review. The symmetric funnel plot does not suggest a risk of bias. An association between periodontitis and arterial hypertension was evidenced. Community oral care services provided by dental hygienists can promote objective oral hygiene and subjective periodontal status in the local community and can help manage hypertension and diabetes. An association of diabetes with increasing age was observed for the lowest social class. A statistically significant association between diabetes was also observed concerning individuals with hypertension, hypercholesterolemia, and periodontal disease. Yet, recent evidence suggests that periodontal disease causes hypertension. Diabetes mellitus is a factor that aggravates the periodontal disease. Periodontal treatment must be cautious and considered, and the periodontist must know the limitations, changes, and disorders that the diabetic patient may present. Any periodontal treatment should be performed once the diabetes is under control